Systolic Blood Pressure and Survival to Very Old Age. Results from the Women's Health Initiative

Bernhard Haring; Chris A Andrews; Kathleen Hovey; Aladdin H Shadyab; Andrea LaCroix; Lisa Warsinger Martin; Milagros C Rosal; Lewis H Kuller; Elena Salmoirago-Blotcher; Nazmus Saquib; Patrick Koo; Deepika Laddu; Marcia L Stefanick; JoAnn E Manson; Sylvia Wassertheil-Smoller; Michael J LaMonte

doi:10.1101/2023.06.22.23291783

Systolic Blood Pressure and Survival to Very Old Age. Results from the Women's Health Initiative

medRxiv [Preprint]. 2023 Jun 29:2023.06.22.23291783. doi: 10.1101/2023.06.22.23291783.

Authors

Bernhard Haring^{1

2}, Chris A Andrews³, Kathleen Hovey³, Aladdin H Shadyab⁴, Andrea LaCroix⁴, Lisa Warsinger Martin⁵, Milagros C Rosal⁶, Lewis H Kuller⁷, Elena Salmoirago-Blotcher⁸, Nazmus Saquib⁹, Patrick Koo¹⁰, Deepika Laddu¹¹, Marcia L Stefanick¹², JoAnn E Manson¹³, Sylvia Wassertheil-Smoller², Michael J LaMonte³

Affiliations

¹ Department of Medicine III, Saarland University Hospital, Homburg, Saarland, Germany.
² Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
³ Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo - SUNY, Buffalo, NY, USA.
⁴ Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA.
⁵ Division of Cardiology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
⁶ Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
⁷ Department of Epidemiology, University of Pittsburgh, PA, USA.
⁸ Departments of Medicine and Epidemiology, Brown University, Providence, RI, USA.
⁹ College of Medicine, Sulaiman AlRajhi University, Saudi Arabia.
¹⁰ Department of Pulmonary, Critical Care, and Sleep Medicine, Baroness Erlanger Hospital, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA.
¹¹ Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.
¹² Department of Medicine Stanford University Medical Center Palo Alto CA. Departments of Obstetrics and Gynecology, Stanford University, Palo Alto, CA.
¹³ Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Abstract

Background: The association between systolic blood pressure (SBP) and longevity is not fully understood. We aimed to determine survival probabilities to age 90 for various SBP levels among women aged ≥ 65 years with or without BP medication.

Methods: We analyzed blood pressure data from participants in the Women's Health Initiative (n=16,570) who were aged 65 or older and without history of cardiovascular disease, diabetes or cancer. Blood pressure was measured at baseline (1993-1998) and then annually through 2005. The outcome was defined as survival to age 90 with follow-up until February 28, 2020.

Results: During a follow-up of 18 years, 9,723 (59%) of 16,570 women survived to age 90. The SBP associated with the highest probability of survival was about 120mmHg regardless of age. Compared to an SBP between 110 and 130 mmHg, women with uncontrolled SBP had a lower survival probability across all age groups and with or without BP medication. A 65-year-old women on BP medication with an interpolated SBP between 110 and 130 mmHg in 80% of the first 5 years of follow-up had a 31% (95% confidence interval, 24%, 38%) absolute survival probability. For those with 20% time in range, the probability was 21% (95% confidence interval, 16%, 26%).

Conclusions: An SBP level below 130 mmHg was found to be associated with longevity among older women. The longer SBP was controlled at a level between 110 and 130 mmHg, the higher the survival probability to age 90. Preventing age-related rises in SBP and increasing the time with controlled BP levels constitute important measures for achieving longevity.

Keywords: Ageing; Old Women; Systolic Blood Pressure.

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Abstract

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