A U-Shaped Association Between Home Systolic Blood Pressure and Four-Year Mortality in Community-Dwelling Older Men

We have assessed the association between excessive orthostatic changes in blood pressure and risk of incident heart failure (HF) in older, community-dwelling men. This was a prospective cohort study of 3505 men (mean age, 68.5 years), who did not have prevalent HF, myocardial infarction, or stroke. Excessive orthostatic change in blood pressure was defined continuously and categorically as orthostatic hypotension (sitting-to-standing decrease in systolic blood pressure ≥20 mm Hg or diastolic blood pressure ≥10 mm Hg), systolic orthostatic hypertension (increase in systolic blood pressure ≥20 mm Hg, diastolic orthostatic hypertension as diastolic blood pressure ≥10 mm Hg), and orthostatic normotension (neither orthostatic hypotension nor orthostatic hypertension). There was a U-shaped association between orthostatic changes in systolic blood pressure and the risk of incident HF; for diastolic blood pressure, only its fall predicted HF. After adjustment for possible confounders, the hazard ratio (95% CI) for incident HF was 1.65 (1.24–2.18) in men with orthostatic hypotension and 0.90 (0.65–1.24) and 1.88 (1.30–2.73) in men with diastolic and systolic orthostatic hypertension, respectively. Both components of orthostatic hypotension were associated with increased risk, although the systolic component was more predictive than the diastolic component. Both orthostatic hypotension and orthostatic hypertension are associated with risk of incident HF in older men. Our findings suggest that orthostatic hypertension is defined by a rise beyond threshold in systolic blood pressure only. Further prospective studies in diverse cohorts are needed to confirm our findings.

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Ascorbic acid increases cardiovagal baroreflex sensitivity in healthy older men

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.01054.2003 ◽

2004 ◽

Vol 286 (6) ◽

pp. H2113-H2117 ◽

Cited By ~ 43

Author(s):

Kevin D. Monahan ◽

Iratxe Eskurza ◽

Douglas R. Seals

Keyword(s):

Oxidative Stress ◽

Blood Pressure ◽

Ascorbic Acid ◽

Systolic Blood Pressure ◽

Sodium Nitroprusside ◽

Baroreflex Sensitivity ◽

Older Men ◽

Acid Infusion ◽

Healthy Men ◽

Phenylephrine Hydrochloride

Cardiovagal baroreflex sensitivity (BRS) declines with advancing age in healthy men. We tested the hypothesis that oxidative stress contributes mechanistically to this age-associated reduction. Eight young (23 ± 1 yrs, means ± SE) and seven older (63 ± 3) healthy men were studied. Cardiovagal BRS was assessed using the modified Oxford technique (bolus infusion of 50–100 μg sodium nitroprusside, followed 60 s later by a 100- to 150-μg bolus of phenylephrine hydrochloride) in triplicate at baseline and during acute intravenous ascorbic acid infusion. At baseline, cardiovagal BRS (slope of the linear portion of the R-R interval-systolic blood pressure relation during pharmacological changes in arterial blood pressure) was 56% lower ( P < 0.01) in older (8.3 ± 1.6 ms/mmHg) compared with young (19.0 ± 3.1 ms/mmHg) men. Ascorbic acid infusion increased plasma concentrations similarly in young (62 ± 9 vs. 1,249 ± 72 μmol/l for baseline and during ascorbic acid; P < 0.05) and older men (62 ± 4 vs. 1,022 ± 55 μmol/l; P < 0.05) without affecting baseline blood pressure, heart rate, carotid artery compliance, or the magnitude of change in systolic blood pressure in response to bolus sodium nitroprusside and phenylephrine hydrochloride infusion. Ascorbic acid (vitamin C) infusion increased cardiovagal BRS in older (Δ58 ± 16%; P < 0.01), but not younger (Δ − 4 ± 4%) men. These data provide experimental support for the concept that oxidative stress contributes mechanistically to age-associated reductions in cardiovagal BRS in healthy men.

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Effect of weight loss on central systolic blood pressure in elderly community-dwelling persons

Hypertension Research ◽

10.1038/hr.2014.108 ◽

2014 ◽

Vol 37 (10) ◽

pp. 933-938 ◽

Cited By ~ 11

Author(s):

Ryuichi Kawamoto ◽

Katsuhiko Kohara ◽

Tateaki Katoh ◽

Tomo Kusunoki ◽

Nobuyuki Ohtsuka ◽

...

Keyword(s):

Blood Pressure ◽

Weight Loss ◽

Systolic Blood Pressure ◽

Community Dwelling ◽

Central Systolic Blood Pressure

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PO-25 HIGHER CENTRAL AND BRACHIAL SYSTOLIC BLOOD PRESSURE IS SELECTIVELY ASSOCIATED WITH WEAKER COGNTIVE PERFORMANCE IN POSTMENOPAUSAL WOMEN BUT NOT OLDER MEN

Artery Research ◽

10.1016/j.artres.2016.08.030 ◽

2016 ◽

Vol 16 (C) ◽

pp. 96

Author(s):

lyndsey E. Dubose ◽

David J. Moser ◽

Taylor Stecklein ◽

Emily Harlynn ◽

William G. Haynes ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Postmenopausal Women ◽

Older Men ◽

Brachial Systolic Blood Pressure

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Abstract 14069: Subclinical Impairment of Left Ventricular Function in Stage A Subjects in a Community-based Population

Circulation ◽

10.1161/circ.132.suppl_3.14069 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Takuya Hasegawa ◽

Masanori Asakura ◽

Hideaki Kanzaki ◽

Hiroshi Asanuma ◽

Seiji Takashio ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Systolic Blood Pressure ◽

Diastolic Dysfunction ◽

Left Ventricular ◽

Community Dwelling ◽

Lv Function ◽

Mitral Annular Velocity ◽

Lv Mass ◽

Lv Diastolic Dysfunction

Introduction: Stage A heart failure (HF) is defined as an asymptomatic state with HF risk factors of hypertension, diabetes, obesity, metabolic syndrome, and atherosclerotic disease in the absence of obvious left ventricular (LV) structural changes including LV hypertrophy (LVH). ACC/AHA guidelines recommend us to treat these risk factors of Stage A HF patients to prevent the progression of HF, hinting us to investigate the prevalence of subclinical impairment of LV function in Stage A subjects in general populations. Methods: We studied 1162 community-dwelling subjects without obvious heart diseases (mean age, 63±11 years; 448 men, 714 women, 63% with hypertension and 11% with diabetes) in the annual health checkup in a rural community, Arita-cho, Saga, Japan. The population was divided into 3 groups; the subjects without either LVH or the HF risk factors ("Stage 0"), the subjects with the HF risk factors in the absence of LVH (Stage A) , and the subjects in the presence of LVH (Stage B). LV systolic and diastolic function were estimated by mitral annular velocity in systole (s'), and the waves of transmitral flow (E) and mitral annular velocity (e'), respectively. LVH was defined as the top quintile of LV mass index. Results: The subjects in Stage A had the lower and higher values of s' and E/e', respectively, and the higher prevalence of LV diastolic dysfunction than those in Stage 0, while 45% of Stages A subjects showed LV diastolic dysfunction (Table). In multivariate logistic analyses, age, systolic blood pressure and LV mass were independent determinants of s', whereas either overlapped or different risk factors, such as age, sex, systolic blood pressure, and body mass index emerged as the determinants for E/e'. Conclusions: Even without obvious LV remodeling, subclinical LV systolic and diastolic impairment was observed in Stage A subjects. The disparity of the risk factors between LV systolic and diastolic dysfunction may indicate their pathophysiological differences.

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Abstract MP023: Changes in Systolic Blood Pressure Differs by Immigration History in a Cohort of Older Mexican Americans

Circulation ◽

10.1161/circ.135.suppl_1.mp023 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Tu My To ◽

John M Neuhaus ◽

May Sudhinaraset ◽

Michelle A Albert ◽

Mary N Haan

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Systolic Blood Pressure ◽

Linear Model ◽

Mexican Americans ◽

Linear Time ◽

Community Dwelling ◽

Foreign Born ◽

Immigration History ◽

The Us

Background: Studies on immigrant health suggest that foreign-born individuals have better health outcomes than their native-born counterparts due to health selection. However, effects of immigration history on changes in cardiovascular conditions and risk factors are less well understood. Objective and Hypothesis: We examined the association between immigration history and change in systolic blood pressure (SBP). We hypothesized that Mexican Americans born outside the US and immigrated after age 30 (FB30+), would have lower SBP at baseline and have slower increase in SBP compared to people who were born in the US (US-B) or immigrated from Mexico before age 30 (FB<30). Methods: Participants come from the Sacramento Area Latino Study on Aging (n=1789), a longitudinal cohort of community-dwelling older Mexican Americans (mean age=70.6 years); 51% were born in Mexico. Immigration history was categorized as US-B, FB<30, and FB30+. SBP measures were available at baseline and at five follow-ups over ten years. A mixed effects linear model was used to examine the association between immigration history and SBP. Other covariates included gender, education, current hypertension medication use, and baseline measures of age, BMI, and diabetes. Follow up time was defined as time since enrollment. Quadratic time was included to account for non-linear change in SBP. Two interaction terms (immigration history x linear time and immigration history x quadratic time) were included to assess differences in SBP change by nativity. Results: The study included 1598 participants after exclusions. The figure shows the predicted average SBP by immigration history over the study period, derived from the mixed linear model. Compared to US-B, the FB<30 and FB30+ experienced an average of 7.3 (95% CI 2.0-12.7) and 7.9 (95% CI 2.2-13.5) mmHg increase in SBP over the study period, respectively. Conclusions: In contrast to current literature, immigrants appeared to be at greater risk for adverse cardiovascular risk factors.

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Abstract P195: Systolic Blood Pressure and 8-Year Mortality in Community-Dwelling Older Adults. Does Frailty Modify This Effect?

Circulation ◽

10.1161/circ.139.suppl_1.p195 ◽

2019 ◽

Vol 139 (Suppl_1) ◽

Author(s):

Kaj Kremer ◽

Ulrike Braisch ◽

Dietrich Rothenbacher ◽

Michael Denkinger ◽

Dhayana Dallmeier

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Systolic Blood Pressure ◽

Community Dwelling ◽

Community Dwelling Older Adults

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PS 06-25 THE ASSOCIATION OF THE BLOOD PRESSURE WITH FRAILTY INDICATORS AMONG COMMUNITY-DWELLING OLDER MEN WITH OR WITHOUT ANTIHYPERTENSIVE TREATMENT

Journal of Hypertension ◽

10.1097/01.hjh.0000500369.94772.c0 ◽

2016 ◽

Vol 34 (Supplement 1) ◽

pp. e173

Author(s):

Mai Kabayama ◽

Kei Kamide ◽

Yasuyuki Gondo ◽

Yukie Masui ◽

Hirochika Ryuno ◽

...

Keyword(s):

Blood Pressure ◽

Antihypertensive Treatment ◽

Older Men ◽

Community Dwelling

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Systolic Blood Pressure and Mortality Among Older Community-Dwelling Adults With CKD

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2010.07.018 ◽

2010 ◽

Vol 56 (6) ◽

pp. 1062-1071 ◽

Cited By ~ 27

Author(s):

Jessica W. Weiss ◽

Eric S. Johnson ◽

Amanda Petrik ◽

David H. Smith ◽

Xiuhai Yang ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Community Dwelling

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Association of Low Blood Pressure with White Matter Hyperintensities in Elderly Individuals with Controlled Hypertension

Journal of Stroke ◽

10.5853/jos.2019.01844 ◽

2020 ◽

Vol 22 (1) ◽

pp. 99-107

Author(s):

Jun Sung Kim ◽

Subin Lee ◽

Seung Wan Suh ◽

Jong Bin Bae ◽

Ji Hyun Han ◽

...

Keyword(s):

Blood Pressure ◽

White Matter ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

White Matter Hyperintensities ◽

Community Dwelling ◽

White Matter Hyperintensity ◽

Periventricular White Matter ◽

Elderly Individuals ◽

Low Blood Pressure

Background and Purpose Both hypertension and hypotension increase cerebral white matter hyperintensities. However, the effects of hypotension in individuals with treated hypertension are unknown. We analyzed the association of low blood pressure with the location and amount of white matter hyperintensities between elderly individuals with controlled hypertension and those without hypertension.Methods We enrolled 505 community-dwelling, cognitively normal elderly individuals from the participants of the Korean Longitudinal Study on Cognitive Aging and Dementia. We measured blood pressure three times in a sitting position using a mercury sphygmomanometer and defined low systolic and diastolic blood pressure as ≤110 and ≤60 mm Hg, respectively. We segmented and quantified the periventricular and deep white matter hyperintensities from 3.0 Tesla fluid-attenuated inversion recovery magnetic resonance images.Results Low systolic blood pressure was independently associated with larger volume of periventricular white matter hyperintensity (P=0.049). The interaction between low systolic blood pressure and hypertension was observed on the volume of periventricular white matter hyperintensity (P=0.005). Low systolic blood pressure was associated with the volume of periventricular white matter hyperintensity in individuals with controlled hypertension (F1,248=6.750, P=0.010), but not in those without hypertension (P=0.380). Low diastolic blood pressure was not associated with the volumes of white matter hyperintensities regardless of presence of controlled hypertension.Conclusions Low systolic blood pressure seems to be associated with larger volume of periventricular white matter hyperintensity in the individuals with a historyof hypertension but not in those without hypertension.

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