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Blood pressure as a predictor of cardiovascular events in the elderly: the William Hale Research Program

Journal of Human Hypertension volume 20, pages 392–397 (2006)Cite this article

Abstract

This study evaluates the association between blood pressure (BP) and the risk of developing cardiovascular disease (CVD) events in the elderly. The Morton Plant Mease Foundation has followed 4008 elderly patients >64 years of age for at least 5 years. Systolic and diastolic blood pressure (SBP and DBP) was divided into categories. Cardiovascular disease events were classified as myocardial infarction, stroke, and CVD-related deaths reported from the National Death Index. Cox proportional hazard ratios were used to assess the relationship between BP and CVD events and controlled for weight, gender, smoker, and alcohol use. Ages <75 and ⩾75 years were assessed separately. After 11.1 years of follow-up, elevated SBP (P=<0.0001) is strongly associated with developing a future CVD event; the relationship is linear and graded and holds for ages above and below 75 years. The frequency of CVD events was lowest in the SBP <120 mm Hg group. In subjects <75 years of age, DBP elevations were not a significant risk factor for CVD events. (relative risk (RR): DBP 70 to <80 mm Hg=0.92; DBP 80 to <90 mm Hg=0.88; DBP ⩾90 mm Hg=1.02.) With subjects ⩾75 years of age, a DBP between 80 and 90 is associated with the lowest significant risk for CVD (RR: DBP 70 to <80 mm Hg=0.74; DBP 80 to <90 mm Hg=0.59; DBP ⩾90=0.71). In conclusion, these findings support the Joint National Committee on Hypertension recommendations for SBP in the elderly. Further studies are warranted to identify optimal DBP for the elderly at various ages.

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Acknowledgements

We thank Jeanne Pitman and Meg Kanuck for their expert editorial assistance. This work was supported in part by a Grant-in-Aid from the Florida/Puerto Rico Affiliate of the American Heart Association (0151028B) and by the Morton Plant Mease Foundation. The Principal Investigator had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Authors and Affiliations

  1. Carillon Executive Health, St Anthony's Health Care, St Petersburg, FL, USA

    S C Masley

  2. Department of Family Medicine, University of South Florida, Tampa, FL, USA

    S C Masley & D D Schocken

  3. Department of Epidemiology, University of South Florida, Tampa, FL, USA

    S E Phillips

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  1. S C Masley
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  2. S E Phillips
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  3. D D Schocken
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Correspondence to S C Masley.

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Masley, S., Phillips, S. & Schocken, D. Blood pressure as a predictor of cardiovascular events in the elderly: the William Hale Research Program. J Hum Hypertens 20, 392–397 (2006). https://doi.org/10.1038/sj.jhh.1002002

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