Faculty Opinions recommendation of Systolic Blood Pressure and Mortality in Community-Dwelling Older Adults: Frailty as an Effect Modifier.

Author(s):  
Andrea Semplicini
Circulation ◽  
2019 ◽  
Vol 139 (Suppl_1) ◽  
Author(s):  
Kaj Kremer ◽  
Ulrike Braisch ◽  
Dietrich Rothenbacher ◽  
Michael Denkinger ◽  
Dhayana Dallmeier

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Amirah Fatin Ibrahim ◽  
Gaik Kin Teoh ◽  
Mei Chan Chong ◽  
Maw Pin Tan ◽  
Siti Mariam Muda ◽  
...  

Abstract Introduction Older adults may remove themselves voluntarily from social activities due to health concerns and physical limitations that leads to loneliness. Additionally, loneliness is associated with poorer health among older adults. Therefore, this study aims to improve health status among community-dwelling older adults in the sub-urban area through this social participation project by creating awareness on empowering the older adults in managing their health and social life. Methods This is a community-based participatory research (CBPR) applying both quantitative and qualitative approaches. Quantitative data was obtained with a standardized data collection document and obtained during a series of health screening programs. The data was analyzed using descriptive statistics. Key results 87 older adults participated in two health screening events. The mean age was 66 ± 6.5 (SD) years, median BMI was 26.5 (IQR=6.4), mean systolic blood pressure was 141 ± 14.6 (SD) mmHg, median diastolic blood pressure was 78 (IQR=10) mmHg, median timed up and go was 10 (IQR=3) seconds, median trail-making test A was 45.8 (IQR=24.4) seconds, median trail-making test B was 115.8 (IQR=99.3) seconds. The mean hand grip strength for male was 30.76 ± 5.1 (SD) kg for right hand and 31.87 ± 24.5 (SD) kg for left hand. The mean hand grip strength for female was 18.40 ± 5.1 (SD) kg for right hand and 17.14 ± 5.0 (SD) kg for left hand. Discussion The results may represent a portion of community-dwelling older adults who are actively engage in community activities such as religious classes, weddings or events. Therefore, the results showed normal values for all physical and mental tests. However, 61% of the participants were overweight or obese and had higher mean systolic blood pressure suggesting the need for more education and awareness on health management.


2013 ◽  
Vol 15 (12) ◽  
pp. 880-887 ◽  
Author(s):  
Marco Canepa ◽  
Yuri Milaneschi ◽  
Pietro Ameri ◽  
Majd AlGhatrif ◽  
Giovanna Leoncini ◽  
...  

2021 ◽  
pp. 089826432110552
Author(s):  
Qian Lian ◽  
Tazeen H. Jafar ◽  
John C. Allen ◽  
Stefan Ma ◽  
Rahul Malhotra

Objectives To assess the association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with mortality among older adults in Singapore. Methods Association of SBP and DBP measured in 2009 for 4443 older adults (69.5±7.4 years; 60–97 years) participating in a nationally representative study with mortality risk through end-December 2015 was assessed using Cox regression. Results Higher mortality risk was observed at the lower and upper extremes of SBP and DBP. With SBP of 100–119 mmHg as the reference, multivariable mortality hazard ratios [HRs (95% confidence interval)] were SBP <100 mmHg: 2.41 (1.23–4.72); SBP 160–179 mmHg: 1.51 (1.02–2.22); and SBP ≥180 mmHg: 1.78 (1.12–2.81). With DBP of 70–79 mmHg as the reference, HRs were DBP <50 mmHg: 2.41 (1.28–4.54) and DBP ≥110 mmHg: 2.16 (1.09–4.31). Discussion Management of high blood pressure among older adults will likely reduce their mortality risk. However, the association of excessively low SBP and DBP values with mortality risk needs further evaluation.


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252212
Author(s):  
Orna A. Donoghue ◽  
Matthew D. L. O’Connell ◽  
Robert Bourke ◽  
Rose Anne Kenny

Orthostatic hypotension (OH) often co-exists with hypertension. As increasing age affects baroreflex sensitivity, it loses its ability to reduce blood pressure when lying down. Therefore, supine hypertension may be an important indicator of baroreflex function. This study examines (i) the association between OH and future falls in community-dwelling older adults and (ii) if these associations persist in those with co-existing OH and baseline hypertension, measured supine and seated. Data from 1500 community-dwelling adults aged ≥65 years from The Irish Longitudinal Study on Ageing (TILDA) were used. Continuous beat-to-beat blood pressure was measured using digital photoplethysmography during an active stand procedure with OH defined as a drop in systolic blood pressure (SBP) ≥20 mmHg and/or ≥10 mm Hg in diastolic blood pressure (DBP) within 3 minutes of standing. OH at 40 seconds (OH40) was used as a marker of impaired early stabilisation and OH sustained over the second minute (sustained OH) was used to indicate a more persistent deficit, similar to traditional OH definitions. Seated and supine hypertension were defined as SBP ≥140 mm Hg or DBP ≥90 mm Hg. Modified Poisson models were used to estimate relative risk of falls (recurrent, injurious, unexplained) and syncope occurring over four year follow-up. OH40 was independently associated with recurrent (RR = 1.30, 95% CI = 1.02,1.65), injurious (RR = 1.43, 95% CI = 1.13,1.79) and unexplained falls (RR = 1.55, 95% CI = 1.13,2.13). Sustained OH was associated with injurious (RR = 1.55, 95% CI = 1.18,2.05) and unexplained falls (RR = 1.63, 95% CI = 1.06,2.50). OH and co-existing hypertension was associated with all falls outcomes but effect sizes were consistently larger with seated versus supine hypertension. OH, particularly when co-existing with hypertension, was independently associated with increased risk of future falls. Stronger effect sizes were observed with seated versus supine hypertension. This supports previous findings and highlights the importance of assessing orthostatic blood pressure behaviour in older adults at risk of falls and with hypertension. Observed associations may reflect underlying comorbidities, reduced cerebral perfusion or presence of white matter hyperintensities.


Sports ◽  
2019 ◽  
Vol 7 (7) ◽  
pp. 167 ◽  
Author(s):  
Sang-Rok Lee ◽  
Edward Jo ◽  
Andy V. Khamoui

Fish oil (FO) has received great attention for its health-enhancing properties. However, its potential synergistic effects with resistance training (RT) are not well established. The purpose of this study was to investigate the effects of FO supplementation during 12-weeks of RT on handgrip strength, physical function, and blood pressure (BP) in community-dwelling older adults. Twenty-eight healthy older adults (10 males, 18 females; 66.5 ± 5.0 years) were randomly assigned to three groups: Control (CON), resistance training (RT), resistance training with FO (RTFO). Handgrip strength, physical function [five times sit-to-stand (5T-STS), timed up and go (TUG), 6-m walk (6MW), 30-s sit-to-stand (30S-STS)], and BP were measured pre- and post-intervention. ANOVA was used with significance set at P ≤ 0.05. Handgrip strength significantly increased in RT (+5.3%) and RTFO (+9.4%) but decreased in CON (−3.9%). All physical function outcomes increased in RT and RTFO. CON exhibited significantly decreased TUG and 30S-STS with no change in 5T-STS and 6MW. BP substantially decreased only in RTFO, systolic blood pressure (−7.8 mmHg), diastolic blood pressure (−4.5 mmHg), mean arterial pressure (−5.6 mmHg), while no change was found in CON and RT. Chronic RT enhanced strength and physical function, while FO consumption combined with RT improved BP in community-dwelling older adults.


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