BLOOD-PRESSURE AND MORTALITY IN ELDERLY PEOPLE AGED 85 AND OLDER - COMMUNITY-BASED STUDY

Objective: To determine whether the inverse relation between blood pre ssure and all cause mortality in elderly people over 85 years of age c an be explained by adjusting for health status, and to determine wheth er high blood pressure is a risk factor for mortality when the effects of poor health are accounted for. Design: 5 to 7 year follow up of co mmunity residents aged 85 years and older. Setting: Leiden, the Nether lands. Subjects: 835 subjects whose blood pressure was recorded betwee n 1987 and 1989. Main outcome measure: All cause mortality. Results: A n inverse relation between blood pressure and all cause mortality was observed. For diastolic blood pressure crude year all cause mortality decreased from 88% (52/59) (95% confidence interval 79% to 95%) in tho se with diastolic blood pressures < 65 mm Hg to 59% (27/46) (44% to 72 %) in those with diastolic pressures > 100 mm Hg. For systolic blood p ressure crude 5 year all cause mortality decreased from 85% (95/112) ( 78% to 91%) in those with systolic pressures < 125 mm Hg to 59% (13/22 ) (38% to 78%) in those with systolic pressures > 200 min Hg. This dec rease was no longer significant after adjustment for indicators of poo r health. No relation existed between blood pressure and mortality fro m cardiovascular causes or stroke after adjustment for age and sex, bu t after adjustment for age, sex, and indicators of poor health there w as a positive relation between diastolic blood pressure and mortality from both cardiovascular causes and stroke. Conclusion: The inverse re lation between blood pressure and all cause mortality in elderly peopl e over 85 is associated with health status.