Premium
Low blood pressure predicts increased mortality in very old age even without heart failure: the Leiden 85‐plus Study
Author(s) -
Poortvliet Rosalinde K.E.,
Blom Jeanet W.,
Craen Anton J.M.,
Mooijaart Simon P.,
Westendorp Rudi G.J.,
Assendelft Willem J.J.,
Gussekloo Jacobijn,
Ruijter Wouter
Publication year - 2013
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfs203
Subject(s) - medicine , blood pressure , hazard ratio , heart failure , cardiology , confidence interval , population , observational study , environmental health
Aims To investigate whether low systolic blood pressure is predictive for increased mortality risk in 90‐year‐old subjects without heart failure, defined by low levels of NT‐proBNP, as well as in 90‐year‐old subjects with high levels of NT‐proBNP. Methods and results This study was embedded in the Leiden 85‐plus Study, an observational population‐based prospective study. All 90‐year‐old participants ( n = 267) were included between 2002 and 2004 and followed up for mortality for at least 5 years. Differences in mortality risks were compared between participants with low systolic blood pressure (≤150 mmHg) and high systolic blood pressure (>150 mmHg) within strata of low NT‐proBNP (<284 pg/mL for women and <306 pg/mL for men = lowest tertile) vs. high NT‐proBNP (middle and highest tertile) at age 90 years. During maximal follow‐up of 7.2 years, 212 participants (79%) died. Among participants with low NT‐proBNP, low systolic blood pressure gave a two‐fold increased risk (hazard ratio 2.0, 95% confidence interval 1.1–3.4) compared with participants with high systolic blood pressure. For participants with high NT‐proBNP, low systolic blood pressure provided a 1.7 increased mortality risk (95% confidence interval 1.2–2.3) compared with high systolic blood pressure. Conclusion Low systolic blood pressure is predictive for increased mortality risk in 90‐year‐old subjects, irrespective of the NT‐proBNP level. Therefore, the absence or presence of heart failure as determined by NT‐proBNP does not influence the prognostic value of low systolic blood pressure with regard to mortality in the oldest old.