Pulse pressure is associated with decline in physical function in older adults

Shao-Yuan Chuang; Wen-Ling Liu; Hao-Min Cheng; Ren-Hua Chung; Chia-Hung Lai; Shu-Chun Chuang; I-Chien Wu; Hsing-Yi Chang; Chao Agnes Hsiung; Wei J Chen; Chih-Cheng Hsu

doi:10.1016/j.maturitas.2024.108000

Pulse pressure is associated with decline in physical function in older adults

Maturitas. 2024 Apr 23:185:108000. doi: 10.1016/j.maturitas.2024.108000. Online ahead of print.

Authors

Affiliations

¹ Institute of Population Health Sciences, National Health Research Institutes, Taiwan. Electronic address: chuangsy@nhri.org.tw.
² Institute of Population Health Sciences, National Health Research Institutes, Taiwan.
³ Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Division of Faculty Development, Taipei Veterans General Hospital, Taipei, Taiwan; Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Public Health, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan.
⁴ Center for Neuropsychiatric Research, National Health Research Institutes, Taiwan; Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.
⁵ Institute of Population Health Sciences, National Health Research Institutes, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Taiwan. Electronic address: cch@nhri.edu.tw.

PMID: 38669896
DOI: 10.1016/j.maturitas.2024.108000

Abstract

Objectives: This study examined the associations between pulse pressure, hypertension, and the decline in physical function in a prospective framework.

Study design: The Healthy Aging Longitudinal Study tracked a group of Taiwanese adults aged 55 or more over an average of 6.19 years to assess pulse pressure and decline in physical function, including in handgrip strength, gait speed, and 6-min walking distance, at baseline (2009-2013) and in the second phase of assessments (2013-2020).

Main outcome measures: Pulse pressure was calculated as the difference between systolic and diastolic blood pressure values. Weakness, slowness, and low endurance were defined as decreases of ≥0.23 m/s (one standard deviation) in gait speed, ≥5.08 kg in handgrip strength, and ≥ 57.73 m in a 6-min walk, as determined from baseline to the second phase of assessment. Linear and logistic regressions were employed to evaluate the associations between pulse pressure, hypertension, and decline in physical function.

Results: Baseline pulse pressure was associated with future handgrip strength (beta = -0.017, p = 0.0362), gait speed (beta = -0.001, p < 0.0001), and 6-min walking distance (beta = -0.470, p < 0001). In multivariable models, only handgrip strength (beta = -0.016, p = 0.0135) and walking speed (beta = -0.001, p = 0.0042) remained significantly associated with future pulse pressure. Older adults with high systolic blood pressure (≥140 mmHg) and elevated pulse pressure (≥60 mmHg) exhibited a significantly increased risk of weakness (odds ratio: 1.30, 95 % confidence interval: 1.08-1.58), slowness (1.29, 1.04-1.59), and diminished endurance (1.25, 1.04-1.50) compared with the reference group, who exhibited systolic blood pressure of <140 mmHg and pulse pressure of <60 mmHg.

Conclusions: Among older adults, pulse pressure is associated with a decline in physical function, especially in terms of strength and locomotion.

Keywords: Old adults; Physical-function decline; Prospective study; Pulse pressure.