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Role of autonomic nervous activity, as measured by heart rate variability, on the effect of mortality in disabled older adults with low blood pressure in long‐term care
Author(s) -
Shibasaki Koji,
Ogawa Sumito,
Yamada Shizuru,
Ouchi Yasuyoshi,
Akishita Masahiro
Publication year - 2018
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.13328
Subject(s) - medicine , blood pressure , hazard ratio , ambulatory blood pressure , cardiology , confidence interval , prospective cohort study , autonomic nervous system , ambulatory , heart rate , heart rate variability
Aim Previous studies have shown the relationship between low blood pressure and high mortality in frail, disabled older adults in long‐term care. However, the mechanism of this relationship is still unclear. We hypothesized that autonomic nervous activity decline is involved in the relationship between low blood pressure and high mortality. Methods The present prospective cohort study recruited 61 participants aged ≥75 years. The data from 24‐h Holter monitoring and blood pressure recorded by ambulatory blood pressure monitoring were collected. Measured data were divided into three categories: 24‐h, daytime and night‐time. From power spectral density in the electrocardiogram, low frequency, high frequency and low frequency/high frequency ratio were calculated. The primary end‐point was death. Results High blood pressure was connected to both high daytime low frequency and high frequency (partial correlation coefficients: 0.42, P  < 0.05 and 0.35, P  < 0.05, respectively). In addition, the low blood pressure group had higher mortality than the high blood pressure group, and disabled older adults in long‐term care and those with elevated daytime systolic and diastolic blood pressure had less risk of mortality compared with those without (systolic: hazard ratio 0.89, 95% confidence interval 0.83–0.96, P  = 0.003; diastolic: hazard ratio 0.98, 95% confidence interval 0.79–1.00, P  = 0.049). The average blood pressures in the high blood pressure groups were approximately 140/80 mmHg and were connected to low mortality. Conclusions Attenuated autonomic nervous activity might lead to low blood pressure in the daytime and high mortality in disabled older adults in long‐term care. Geriatr Gerontol Int 2018; 18: 1153–1158 .

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