Long-Term Blood Pressure Variability and Physical Performance in Older Adults

IF 2.5 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Kerry M. Sheets, Katherine L. Webb, Robyn L. Woods, Suzanne G. Orchard, Lawrence Beilin, Michelle A. Fravel, Christopher M. Reid, Kevan R. Polkinghorne, Rory Wolfe, Zhen Zhou, Joanne Ryan, Anne M. Murray, Michael E. Ernst
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Abstract

High variability in long-term blood pressure (BPV) independently predicts cardiovascular disease and cognitive decline. Increased BPV and declining physical performance may share mechanistic pathways. However, associations of BPV with gait speed and grip strength have not been examined. We completed a gender-stratified analysis of 16 692 participants enrolled in ASPREE/ASPREE-XT. Systolic and diastolic BPV were estimated from baseline-year 2 (Y2); gait speed/grip strength were assessed every 1–2 years following this period. Linear mixed models examined gait speed/grip strength trajectories over a median of 7.3 years of follow-up after Y2. Following adjustment, men with SBPV in tertile 3 (T3) versus T1 had slower gait speed at Y2 (0.021 m/s slower) and greater declines in gait speed (0.003 m/s greater decline/year, p < 0.001). Women with SBPV in T3 versus T1 had slower gait speed at Y2 (0.018 m/s slower), but similar rates of gait speed decline. Men with higher SBPV had weaker grip strength at Y2 (0.994 kg weaker for BPV T3 vs. T1) and greater declines in grip strength (0.016 kg greater decline/year/5 mmHg increase in BPV, p = 0.006). Women with BPV in T3 versus T1 had 0.486 kg weaker grip strength at Y2, but similar rates of grip strength decline. Associations of DBPV and SBPV with gait speed/grip strength were largely consistent. In summary, we found that higher BPV was independently associated with slower gait speed and weaker grip strength cross-sectionally in men and women, but only associated with trajectories of gait speed and grip strength in men. Future studies should examine high BPV as a target to preserve physical performance.

Trial Registration: ISRCTN number: ISRCTN83772183; ClinicalTrials.gov identifier: NCT01038583

Abstract Image

老年人的长期血压变异性和身体表现。
长期血压(BPV)的高变异性独立预测心血管疾病和认知能力下降。BPV的增加和身体机能的下降可能有共同的机制途径。然而,BPV与步态速度和握力的关系尚未被研究。我们对参加ASPREE/ASPREE- xt的16692名参与者进行了性别分层分析。从基线第2年(Y2)开始估计收缩期和舒张期BPV;在此期间,每1-2年评估一次步态速度/握力。线性混合模型检查了Y2后中位7.3年的步态速度/握力轨迹。调整后,与T1相比,第3期(T3) SBPV的男性在Y2时的步态速度较慢(慢0.021 m/s),步态速度下降幅度较大(慢0.003 m/s)
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来源期刊
Journal of Clinical Hypertension
Journal of Clinical Hypertension PERIPHERAL VASCULAR DISEASE-
CiteScore
5.80
自引率
7.10%
发文量
191
审稿时长
4-8 weeks
期刊介绍: The Journal of Clinical Hypertension is a peer-reviewed, monthly publication that serves internists, cardiologists, nephrologists, endocrinologists, hypertension specialists, primary care practitioners, pharmacists and all professionals interested in hypertension by providing objective, up-to-date information and practical recommendations on the full range of clinical aspects of hypertension. Commentaries and columns by experts in the field provide further insights into our original research articles as well as on major articles published elsewhere. Major guidelines for the management of hypertension are also an important feature of the Journal. Through its partnership with the World Hypertension League, JCH will include a new focus on hypertension and public health, including major policy issues, that features research and reviews related to disease characteristics and management at the population level.
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