Abstract 14429: High Pulse Pressure is Associated With Reduced Gait Speed in Community-Dwelling Older Adults: Findings From the Life-P Study
Reduced long-distance gait speed, a measure of physical function, is associated with falls, late-life disability, institutionalization, cardiovascular morbidity and mortality. Aging is also accompanied by an increase in arterial stiffness and pressure from wave reflections that contribute to a widening of pulse pressure (PP). By altering ventricular-vascular coupling, this increased pulsatile afterload may affect physical function.
Purpose: To test the hypothesis that PP is associated with physical function (i.e. long-distance gait speed) in community-dwelling older adults in the Lifestyle Interventions and Independence For Elders Pilot (LIFE-P) study.
Methods: Brachial BP (by auscultation and sphygmomanometry) and 400-meter gait speed (average speed maintained over a 400-meter walk at “usual” pace) was assessed in 424 older adults between the ages of 70-88 yrs (mean age = 77 yrs; 31% male). PP was calculated as systolic blood pressure (SBP) - diastolic blood pressure (DBP).
Results: Patients with a history of coronary artery disease, stroke, and osteoarthritis were excluded leaving 389 participants for analysis. According to backward stepwise multiple regression, PP was significantly associated with 400-meter gait speed (β=-0.12, R2 change = 0.02, p<0.05). Other significant predictors of gait speed included: handgrip strength (β=0.35, R2 change = 0.07), body weight (β=-0.32, R2 change = 0.05), and age (β=-0.27, R2 change = 0.07). The steady component of blood pressure, mean arterial pressure, was not a predictor of gait speed (p>0.05). When separated according to tertiles of PP, participants with the highest PP had significantly slower gait speed than those with the lowest PP (p<0.05). When older adults were separated according to those that completed the 400m- walk test without stopping versus those that had to stop one or more times during the task (n=43), PP was significantly higher in those that had to stop versus those that did not (p<0.05).
Conclusions: Elevated PP is associated with reduced gait speed and physical function in community-dwelling older adults. These findings suggest that vascular senescence and altered ventricular-vascular coupling may contribute, in part, to the deterioration of physical function with advancing age.
- © 2010 by American Heart Association, Inc.