IS LOW BLOOD-PRESSURE IN ELDERLY PEOPLE JUST A CONSEQUENCE OF HEART-DISEASE AND FRAILTY

Low blood pressure has been associated with increased mortality in old er people, but it is unclear whether the hypotension is a risk in its own right or just a marker of disease. In this study we investigated t he extent to which those in the lowest decile of systolic and diastoli c pressures could be predicted by measures of cardiovascular disease a nd frailty. We studied 782 people 70 years and over drawn from the onl y group of general practices in a rural township. Hypotension was defi ned separately for systolic and diastolic blood pressures as a pressur e less than the tenth percentile for the sample as a whole. This was a systolic pressure of less-than-or-equal-to 122 mmHg and a diastolic p ressure of less-than-or-equal-to 68 mmHg. There was a significant rela tionship between low systolic blood pressure and male sex, history of myocardial infarction by questionnaire and low body mass index (BMI), and between low diastolic pressure and male sex, history of angina and myocardial infarction, use of one or more hypotensive drugs, low BMI, low corrected arm muscle area, low self-maintenance score and the use of two or more home services. There was no association with ECG abnor malities. In the multivariate analysis only 4.200 of those with low di astolic pressure and none of those with low systolic pressure could be correctly classified. Hypotension in old age is only partially explai ned by established cardiovascular disease and frailty.