We assessed the prevalence of falling blood pressure among older adults and
its relationship to subsequent outcomes, using public use data from four s
ites of the Established Populations for Epidemiologic Studies of the Elderl
y. Seventeen percent of subjects had a decrease in systolic blood pressure
of 20 mm Hg or greater and 22% had a decrease in diastolic blood pressure o
f 10 mm Hg or greater between year 0 and year 3. Falling systolic and diast
olic blood pressure was associated with increased all-cause mortality (OR 1
.5, 95% Cl 1.3, 1.7), cardiovascular mortality OR 1.6, 95% Cl 1.3. 1.9) and
all cardiovascular events (OR 1.4, 95% CI 1.2, 1.6) in the subsequent 3 ye
ars (years 4 to 6). Increasing amount of fall in blood pressure was associa
ted with increasing risk of mortality. The magnitude of effect of falling b
lood pressure on adverse outcomes declined and became nonsignificant after
adjusting for comorbidity and functional status at baseline. Thus, falling
blood pressure is common among older adults and is a marker for underlying
poor health and subsequent mortality. (C) 2001 Elsevier Science Inc. All ri
ghts reserved.