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Low systolic blood pressure and mortality from all-cause and vascular diseases among the rural elderly in Korea; Kangwha cohort study

Authors
 Sang-Wook Yi  ;  Seri Hong  ;  Heechoul Ohrr 
Citation
 MEDICINE, Vol.94(2) : 245, 2015 
Journal Title
 MEDICINE 
ISSN
 0025-7974 
Issue Date
2015
MeSH
Age Factors ; Aged ; Blood Pressure Determination ; Cause of Death* ; Confidence Intervals ; Female ; Follow-Up Studies ; Humans ; Hypotension*/complications ; Hypotension*/diagnosis ; Hypotension*/epidemiology ; Korea/epidemiology ; Male ; Middle Aged ; Proportional Hazards Models ; Risk Factors ; Rural Population/statistics & numerical data ; Vascular Diseases/etiology ; Vascular Diseases/mortality* ; Vascular Diseases/physiopathology
Abstract
The association between low systolic blood pressure (SBP) and vascular diseases is unclear. The aim of this study was to prospectively examine the association between SBP, especially low SBP, and mortality from all causes and vascular diseases among the elderly in Korea. Six thousand two hundred ninety four residents in a rural community were followed-up for deaths from 1985 to 2008. The adjusted hazard ratios (aHR) and 95% confidence intervals were calculated by Cox proportional hazard model. A stratified analysis was conducted by age at enrollment. Among the elderly aged 65 and above, the lowest SBP (<100 mm Hg) group had an elevated aHR for mortality from vascular diseases (aHR = 2.1, 95% CI = 1.2-3.9) including stroke (aHR = 2.4, 95% CI = 0.9-6.3) and ischemic heart diseases (aHR = 5.1, 95% CI = 1.0-26.0) compared to those with SBP of 100-119 mm Hg, while higher SBP was associated with higher mortality. This J-curve association was generally maintained when analysis was restricted to those with fair or good self-rated health, or those with no known vascular diseases. In people below 65, increasing SBP nearly monotonically increased the mortality from all-cause and vascular diseases. Our results suggest that elderly persons with low SBP should be treated with caution, since low SBP may increase vascular mortality.
Files in This Item:
T201500390.pdf Download
DOI
10.1097/MD.0000000000000245
Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Ohrr, Hee Choul(오희철)
Hong, Se Ri(홍세리)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139463
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