AGE-ASSOCIATED CHANGES IN BLOOD-PRESSURE IN A LONGITUDINAL-STUDY OF HEALTHY-MEN AND WOMEN

Background. Current knowledge of age-associated increases in blood pre ssure is based primarily on unscreened population studies that may not be representative of healthy men and women. We examined longitudinal patterns of change in blood pressure in healthy male and female volunt eers from the Baltimore Longitudinal Study of Aging (BLSA). Methods. L ongitudinal mixed-effects regression models are used to estimate the a ge-associated changes in brood pressure in 1307 men (age 17-97) and 33 3 women (age 18-93) who have been followed for up to 32 years (mean: 8 .4 years for men and 3.4 years for women) and who have been screened f or hearth problems or medications that affect blood pressure. Results. On average, systolic pressure is relatively stable in men and women u ntil approximately age 45, increases at 5-8 mm Hg per decade in middle age, then accelerates in men and stabilizes in women. Diastolic press ure increases at 1 mm Hg per decade at all ages in men, whereas in wom en the rate of change in diastolic pressure increases in middle age an d then plateaus and may decline after age 70. Additional findings incl ude: (a) BLSA cross-sectional and longitudinal findings are more simil ar than has been observed in studies of unscreened samples; (b) there is no evidence of a gender cross-over in this group of healthy men and women; and (c) compared to previous studies of unscreened samples, he althy BLSA men and women show a weaker association between baseline bl ood pressure and subsequent rate of blood pressure change. Conclusions . These findings suggest that several previously described age-associa ted patterns of blood pressure change partially reflect the effects of hypertension and its treatment, rather than intrinsic age changes in the blood pressure of healthy individuals.