Older women have higher probability of surviving to age 90 years with systolic BP control

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Key takeaways:

  • Women who survived to age 90 years were less likely to have a history of hypertension or use BP medication.
  • Maintaining target BP for a larger proportion of time was associated with higher survival probability.

Attaining systolic BP between 110 mm Hg and 130 mm Hg was associated with higher probability of surviving to 90 years of age among women aged 65 years and older, according to results of a real-world study published in Circulation.

“Over the past few decades, age-related systolic blood pressure (SBP) increase has been regarded as a feature of aging,” Bernhard Haring, MD, MPH, head of echocardiography and the imaging outpatient clinic at Saarland University Medical Center in Homburg, Germany, and colleagues wrote. “The population is aging rapidly, with adults and particularly women over 65 years of age representing the fastest-growing segment of the U.S. adult population; therefore, determining which SBP levels specifically are associated with survival to very old age is important to identify strategies that may lengthen lifespan and health span.”

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Women who survived to age 90 years were less likely to have a history of hypertension or use BP medication. Source: Adobe Stock

Haring and colleagues conducted a study that included 16,570 women (mean age, 70.6 years; standard deviation, 3.4 years; range, 63-79 years) who enrolled in the Women’s Health Initiative between 1993 and 1998 and were considered eligible to survive to age 90 years by Feb. 18, 2020.

Median follow-up was 19.8 years.

The researchers measured participants’ BP annually following enrollment, with up to seven BP measurements per woman. The researchers also estimated the proportion of time participants’ systolic BP was in the recommended range of 110 mm Hg to 130 mm Hg over the previous 5 years.

More than half of women in the study lived to age 90 years (59%). Those who did so were slightly older at baseline than those who died (mean age, 71.2 years vs. 69.8 years) and were less likely to have a history of hypertension (49% vs. 57%) or use BP medication (31% vs. 40%).

Attaining systolic BP within the recommended range appeared associated with the greatest likelihood of surviving to very old age. The pattern appeared similar based on BP medication use, Haring and colleagues wrote, but women on BP medication had lower survival probability than women not on such medication.

Participants’ survival probability increased with the larger proportion of time spent in the target BP range. For example, among women aged 80 years, survival probabilities ranged from 66% (95% CI, 64-69) among those who never attained target BP to 77% (95% CI, 74-79) for women in the target range 100% of the time. The researchers observed a similar trend among younger women, with survival probabilities ranging from 30% (95% 26-34) for women aged 70 years spending no time in the target zone, to 43% (95% CI, 38-48) among those spending 100% of time in the target zone. However, this association did not persist past 80 years.

“The age-related BP estimates in conjunction with survival probabilities to 90 years of age illustrated here emphasize the importance of maintaining well-controlled BP levels even at older ages,” Haring and colleagues wrote. “These findings should encourage primary care physicians, policy makers and other stakeholders to ensure adequate BP control in this vulnerable patient group.”

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