Abstract 2397: Postural Dysregulation in Systolic Blood Pressure Predicts Cardiovascular Mortality in Apparent Healthy Elderly Living in the Community
Background: Postural dysregulation in blood pressure is frequently found in elderly with autonomic dysfunction. The purpose of this study is to clarify whether postural dysregulation in systolic blood pressure (SBP) affects cardiovascular mortality in community-dwelling elderly.
Methods: We recruited the apparent healthy 966 elderly over 65 yrs. (379 men, 587 women, mean age: 75 yrs.) in the rural town of Kahoku, Japan. SBP was measured with an automatic cuff-oscillometric device. By using the differences in SBP (dSBP) at standing and supine positions, we divided the subjects into 3 subgroups; the PHYPO group: 91 subjects with postural hypotension (dSBP≤− 20mmHg), the PHT group: 65 subjects with postural hypertension (dSBP≥20mmHg), the PNT group: 810 subjects with postural normotension (−20<dSBP<20mmHg).
Results: 238 deaths, including 43 cardiovascular deaths were found during observation period (mean 7 years.). Both PHYPO and PHT were an independent risk factor for death, after adjusting age, gender, BMI, SBP at sitting position, smoking and history of hypertension, diabetes or hyperlipidemia (PHYPO: Adjusted OR: 3.7, 95%CI: 2.6 –5.1, p<0.0001, PHT: Adjusted OR: 3.4, 95%CI: 2.4 – 4.9, p<0.0001). Both PHYPO and PHT were also a significant determinant for cardiovascular death (PHYPO: Adjusted OR: 6.6, 95%CI: 3.0 –14.8, p<0.0001, PHT: Adjusted OR: 7.3, 95%CI: 3.3–16.2, p<0.0001).
Conclusion: Postural dysregulation in systolic blood pressure is a powerful predictor of cardiovascular mortality in apparent healthy elderly.