Relationship between Blood Pressure and Impairment of Cognitive Function In Some Rural Residents Aged 60-64
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Objectives : Face-to-face interviews were conducted to investigate the relationship between blood pressure and the impairment of cognitive function in rural elderly (N=932) aged 60-64 in Dalsung County, April to September in 1996 Methods : Impairment of cognitive function was defined as a score of less than 23 by the Korean version of the Mini-Mental State Examination (MMSEK). Blood pressure was measured once in each subject using a portable automatic sphygmomanometer. Results : By univariate logistic regression on males, no category of systolic blood pressure bore statistical significance. Groups with diastolic blood pressures of, less than 80 mmHg, 90-94 mmHg, and more than 95mmHg had odds ratios of more than one compared with the reference group (80-89 mmHg). This was most significant in the group with blood pressures lower than 80 mmHg, which had a statistically significant odds ratio of 1.68 (95% confidence interval CI; 1.02-2.75). No category of blood pressure was statistically significant in females. Multivariate logistic regression for males, with adjustment for age, educational attainment, smoking, alcoholic drinking, body mass index, atherosclerotic disease, and antihypertensive medication use, did not alter the odds ratios significantly in terms of systolic blood pressure. However, the group with diastolic blood pressure of less than 80 mmHg had an increased odds ratio of 2.01 (95% CI; 1.15-3.52) compared with the reference group. In females, systolic blood pressure did not alter the odds ratio, but the group with a diastolic blood pressure of less than 80 mmHg had a statistically significant odds ratio of 0.57 (95% CI; 0.37-0.89). Conclusions : These results suggest that the relationship between blood pressure and cognitive function status is stronger diastolic than systolic blood pressure and that there is a complex relationship between blood pressure and cognitive function by sex.Cite
To examine whether baseline high blood pressure and antihypertensive treatment predicts cognitive decline in elderly individuals.A longitudinal population-based study of elderly individuals (n = 1,373) in Nantes (western France) was undertaken. Individuals 59 to 71 years of age were selected from electoral rolls. High blood pressure at baseline was defined as systolic blood pressure > or =160 mm Hg or diastolic blood pressure > or =95 mm Hg. Cognitive decline was defined as a drop of 4 points or more on the Mini-Mental State Examination between baseline and the 4-year assessment.There is an association between high blood pressure at baseline and cognitive decline at the 4-year assessment (odds ratio, 2.8; 95% CI, 1.6 to 5.0). In participants with high blood pressure, the risk of cognitive decline was 4.3 (95% CI, 2.1 to 8.8) in those without antihypertensive therapy and 1.9 (95% CI, 0.8 to 4.4) in those being treated. In participants with high blood pressure both at baseline and at the 2-year assessment, the risk for untreated participants was 6.0 (95% CI, 2.4 to 15.0) compared with 1.3 (95% CI, 0.3 to 4.9) in treated participants.High blood pressure was associated with cognitive decline. In individuals with high blood pressure, cognitive decline occurred in a relatively short time period and the risk was highest in untreated hypertensive patients.
Cognitive Decline
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Cross-sectional study
Sports medicine
Human physiology
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The purpose of the study was to determine whether poor hypertension control is due to lack of systolic blood pressure control, diastolic blood pressure control or both. We analyzed data from 10854 Chinese patients (age ≥ 35 years old) with hypertension from 60 villages of Fuxin County between 2004 and 2005 in Liaoning province of China. We screened for hypertension with a systolic blood pressure of ≥ 140 mmHg or a diastolic blood pressure of ≥ 90 mmHg, or those who were taking antihypertensive therapy at the time of the examination. Blood pressure control was defined as systolic goal (systolic < 140 mmHg), diastolic goal (diastolic < 90 mmHg), or both (systolic < 140 mmHg and diastolic < 90 mmHg). Statistical analysis was performed using the software of Statistical Program for Social Sciences (SPSS) version 11.5, and a value of P < 0.05 was considered to indicate statistical significance. Of 10854 hypertensive patients (mean age 56.2 years, 50.2% women), 14.7% were controlled to systolic goal, 33.9% were controlled to diastolic goal, and 1.0% were controlled to both. Among 2450 subjects who were undergoing antihypertensive therapy (22.6% of all hypertensive patients), 6.5% were controlled to systolic goal, 22.1% were controlled to diastolic goal, and 4.3% were controlled to both. Thus, poor systolic blood pressure control was overwhelmingly responsible for poor rates of overall control to goal. Covariates associated with lack of systolic control in treated patients included older age (compared with patients aged 35 to 44 years, Odds Ratio (OR) for age 55 to 64 years, 1.814, 95% CI 1.087-3.028; OR for age ≥ 65 years, 2.753, 95% CI 1.558-4.863) and prevalent CVD (cardiovascular disease) (OR 0.666, 95% CI 0.464-0.956). The same covariates were associated with the lack of both control (systolic < 140 mmHg and diastolic < 90 mmHg). In this rural community-based sample of middle-aged and older subjects, overall rates of antihypertensive therapy and hypertension control were lower than those in the National Health and Nutrition Examination Survey conducted in 2002. Poor blood pressure control was overwhelmingly due to lack of systolic control, even among the treated subjects. Therefore, greater emphasis should be placed by clinicians and policymakers on the achievement of systolic goal levels in all hypertensive patients, especially in the elderly.
Systolic hypertension
Isolated systolic hypertension
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We examine how combinations of systolic and diastolic blood pressure levels and pulse pressure levels predicted mortality risk.Respondents are those aged over 50 from the Health and Retirement Study (N=10,366) who provided blood pressure measures in 2006/2008.Systolic and diastolic blood pressures were measured three times; and we averaged the three readings.Pulse pressure was calculated as systolic minus diastolic blood pressure.Seven combinations of systolic and diastolic blood pressure (low/normal/high of each) and three levels of pulse pressure (low/normal/high) were used to categorize blood pressure.Over 1 to 10 years of follow-up (average follow-up time of 7.8 years), 2,820 respondents died after blood pressure measurement in 2006/2008.Potential covariates including age, gender, education, BMI, total cholesterol, HbA1c, antihypertensive medication intake and lifetime-smoking pack years were adjusted in Cox proportional hazard models and survival curves.The blood pressure subgroup with low systolic blood pressure (<90 mmHg) and low diastolic blood pressure (< 60 mmHg) had the highest relative risk of mortality (HR=2.34,95% CI: 1.45-3.80),followed by those with normal systolic blood pressure but low diastolic blood pressure (HR=1.45,95% CI: 1.17-1.81)among those with cardiovascular conditions at baseline.For those without cardiovascular conditions at baseline, low blood pressure, either systolic or diastolic, was not related to mortality.Those with high levels of both systolic and diastolic blood pressure had a higher risk of mortality than those with both blood pressures normal but no other subgroups with low blood pressure differed from normal/normal in predicting mortality.Pulse pressure did not predict mortality.How high and low blood pressures are related to mortality needs to be examined by jointly looking at systolic and diastolic blood pressure.
Pulse pressure
Prehypertension
Systolic hypertension
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Chinese population
Depression
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This study examines change in systolic blood pressure, diastolic blood pressure, and total serum cholesterol over a three-year span in two groups of men aged 55–74 years at follow-up: 1) 262 men who were working at baseline but retired at follow-up, and 2) 409 age peers who remained employed at both measurement times. Measures were obtained from medical examinations conducted since the early 1970s as part of the prospective Veterans Administration Normative Aging Study in Boston. Regression analyses showed an average increase of 3.44 mmHg in systolic blood pressure, 1.62 mmHg in diastolic blood pressure, and 5.56 mg/dl in cholesterol for retirees compared with workers. The relative increases in the blood pressure variables were statistically significant. However, a logistic regression analysis did not show a greater incidence of hypertension among retirees compared with workers. The odds ratio, standardized for baseline blood pressure, body mass index, and age, was 0.90 (95 per cent confidence interval 0.56-1.45). Among retirees only, analyses of covariance showed that levels of blood pressure and cholesterol were comparable from one six-month interval to the next in the three years preceding and following retirement. Overall, the effects of retirement were not of sufficient magnitude to conclude that retirement had a clinically significant impact on blood pressure or cholesterol.
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This study sought to determine if individuals with high-normal blood pressure (diastolic blood pressure of 85-89 mm Hg) progress to hypertension more frequently than those with normal blood pressure (diastolic blood pressure less than 85 mm Hg), thus advancing to a higher cardiovascular risk category. Individuals from the Framingham Heart Study were placed in normal and high-normal blood pressure categories and followed for 26 years for the development of hypertension. With hypertension defined as a diastolic blood pressure of 95 mm Hg or greater or the initiation of antihypertensive therapy, 23.6% of men and 36.2% of women with normal blood pressure developed hypertension compared with 54.2% of men and 60.6% of women with high-normal blood pressure. The relative risk for the development of hypertension associated with high-normal blood pressure was 2.25 for men (95% confidence interval [CI], 1.8-2.8; p less than 0.0001) and 1.89 for women (95% CI, 1.5-2.3; p less than 0.0001). The age-adjusted relative risks estimated by the proportional hazards model were 3.36 for men and 3.37 for women (p less than 0.001). Among those risk factors examined, baseline systolic and diastolic blood pressure, Metropolitan relative weight, and change in weight over time were significant predictors of future hypertension in men and women whose initial blood pressure was normal. For men with high-normal blood pressure, systolic blood pressure and change in weight were identified as risk factors for future hypertension. These results indicate that the probability of individuals with blood pressure in the high-normal range developing hypertension is twofold to threefold higher than in those with normal blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
Prehypertension
Framingham Heart Study
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to investigate the relationship between blood pressure over time and mortality in elderly patients with type 2 diabetes mellitus (T2DM).prospective observational cohort study.primary care, Zwolle, The Netherlands.patients with T2DM aged 60 years and older (n = 881). The cohort was divided into two age categories: 60-75 years and older than 75 years.updated means for systolic, diastolic and pulse pressures were calculated after a median follow-up time of 9.8 years. These values were used as time-dependent covariates in a Cox proportional hazard model. Main outcome measures were all-cause and cardiovascular mortality.all of the blood pressure measures were inversely related to all-cause mortality in elderly diabetic patients (>75 years). Furthermore, these relationships were specifically found in elderly patients treated with antihypertensive medication at baseline. A decrease of 10 mm Hg in systolic blood pressure, diastolic blood pressure and pulse pressure led to a mortality increase of 22% [95% confidence interval (95% CI): 13-31%], 30% [95% CI: 13%-46%] and 22% [95% CI: 11%-33%], respectively. In the low age group (60-75 years), no relationship was found between blood pressure and mortality.blood pressure is a marker for mortality in elderly T2DM patients; however, the relationship is inverse.
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The authors examined the association of blood pressure with cognitive function as assessed by the Mini-Mental State Examination (MMSE) in a community-based Swedish cohort of 1,736 people aged 75–101 years. Age, sex, education, antihypertensive medication use, heart disease, and stroke were considered as covariates. Multiple linear regression analysis indicated that both systolic and diastolic blood pressure, measured in 1987–1989, were positively and significantly related to baseline MMSE score; baseline systolic pressure was also positively and significantly related to follow-up MMSE score, measured after an average period of 40.5 months among subjects who were not taking antihypertensive medication at baseline. Furthermore, in the nontreated group, multiple logistic regression showed that individuals with a baseline systolic pressure less than 130 mmHg had an odds ratio of 1.88 (p = 0.05) for follow-up cognitive impairment (MMSE score <24) compared with those whose systolic pressure was 130–159 mmHg. An increased but not statistically significant risk of cognitive impairment was associated with high blood pressure (systolic pressure ≥180 mmHg or diastolic pressure ≥95 mmHg) only in persons taking antihypertensive medication at baseline. Subjects with systolic pressure of 160–179 mmHg tended to be at lower risk of cognitive impairment. These results may support the view that a certain blood pressure level, particularly a systolic pressure of at least 130 mmHg, is important to the maintenance of cognitive functioning in the very old. They also suggest that severe hypertension that is not well controlled (systolic pressure ≥180 mmHg or diastolic pressure ≥95 mmHg) is still a threat to cognitive function in this age group. However, the use of blood pressure measurements made at a single visit and the relatively short follow-up period should be considered when interpreting these results. Am J Epidemiol 1997; 145: 1106-13.
Mini–Mental State Examination
Prehypertension
Stroke
Pulse pressure
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Objective To explore the significance of healthy education on blood pressure control in hypertension patients. Methods 300 patients above 45 years old from a community hospital in Beijing from April 2011 to April 2012 were collected and randomly divided into two groups with 150 cases in each groups. The control group was treated with conventional treatment, observation group was treated with health education combined with conventional antihypertensive therapy. Then the lifestyle, systolic blood pressure, diastolic blood pressure and pulse pressure during day and night, and the SF-36 scale scores in both groups were observed. Results In observation group, medication adherence(65.3%), mental health(57.3%), reasonable diet(55.3%) and regular exercise(36.0%) were higher than that in control group(34.0%, 33.3%, 28.0%, 15.3% respectively), the differences were statistically significant(P 0.01). After healthy education, the systolic blood pressure [(124.55±13.73) mm Hg], pulse pressure [(39.45±7.71) mm Hg] in daytime, the systolic blood pressure [(119.22±17.42) mm Hg] and diastolic blood pressure [(77.62±10.39) mm Hg] in the night in observation group were lower than that those in control group [(133.36±16.09),(43.63±10.42),(126.48±17.17),(83.81± 12.67) mm Hg respectively)], the differences were statistically significant(P 0.05). The SF-36 scale of body pain, physiological function, physiological competency, general health, vitality, social function, emotion, mental health in observation group were all better than those in control group, the differences were statistically significant(P 0.01). Conclusion Health education can effectively improve hypertension patients' compliance, it is important to control blood pressure fluctuations.
Pulse pressure
Prehypertension
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