Functional Status Modifies the Association of Blood Pressure with Death in Elders: Health and Retirement Study

Objective To examine whether grip strength, gait speed, and the combination of the two physical functioning measures modified the association of systolic BP (SBP) and diastolic BP (DBP) with mortality. Design Nationally representative cohort study. Setting Health and Retirement Study. Participants 7...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) 2017-07, Vol.65 (7), p.1482-1489
Main Authors: Wu, Chenkai, Smit, Ellen, Peralta, Carmen A., Sarathy, Harini, Odden, Michelle C.
Format: Article
Language:English
Subjects:
Aged
Blood pressure
Blood Pressure - physiology
Death
Female
Gait
gait speed
Geriatrics
grip strength
Hand Strength - physiology
Humans
Hypertension - mortality
Longitudinal Studies
Male
Mortality
Risk Factors
Surveys and Questionnaires
United States
Walking - statistics & numerical data
Walking Speed - physiology
Wrist
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Summary:Objective To examine whether grip strength, gait speed, and the combination of the two physical functioning measures modified the association of systolic BP (SBP) and diastolic BP (DBP) with mortality. Design Nationally representative cohort study. Setting Health and Retirement Study. Participants 7,492 U.S. adults aged ≥65 years. Measurements Grip strength was measured by a hand dynamometer and classified as normal (≥16 kg for female; ≥26 kg for male) and weak. Gait speed was assessed over a 98.5‐inch walk and classified as non‐slow (≥0.60 m/s for female; ≥0.52 m/s for male) and slow. Results Over an average follow‐up time of 6.0 years, 1,870 (25.0%) participants died. After adjustment for socio‐demographic, behavioral, and clinical measures, elevated SBP (≥150 mmHg) and DBP (≥90 mmHg) was associated with a 24% (95% CI, 7–43%) and 25% (95% CI, 5–49%) higher mortality among participants with normal grip strength. In contrast, elevated SBP and DBP was associated with a 6% (95% CI, 31 to −27%) and a 16% (95% CI, 46 to −26%) lower mortality among those with weak grip strength (P‐values of interactions: both=.07). The inverse relations between BP with death were most pronounced among slow walkers with weak grip strength. The HRs of elevated SBP and DBP for death was 0.85 (95% CI, 0.56–1.29) and 0.53 (95% CI, 0.30–0.96), respectively, and was substantially different from non‐slow walkers with normal grip strength (HR = 1.24 and 1.15, respectively; P‐values of interactions: both
ISSN:0002-8614
1532-5415
DOI:10.1111/jgs.14816