High BP tied to disability in older adults

Uncontrolled high blood pressure (hypertension) raises the risk of disability in older adults, according to a new report.

“Considering that 65 percent of the elderly population has hypertension and that 71 percent of them have uncontrolled hypertension, it is contributing significantly to disability and to healthcare expenditure in the US,” warn researchers in the journal Hypertension.

Dr. Ihab Hajjar, from Harvard Medical School in Boston, and associates analyzed data from 999 adults who took part in the Charleston Heart Study from 1960 to 1993. Their average age was 68.5 years and 57 percent of them were women and 39 percent were African American.

The study subjects had their blood pressure measured at multiple points throughout the study and a variety of standard tests were used to assess physical function and disability during follow-up.

Increases in systolic blood pressure during the study were associated with reduced function on all of the tests. Systolic BP is the top number in blood pressure readings that represents pressure while the heart contracts.

The presence of hypertension (defined as 140/90 mm Hg or greater or the use of antihypertensive agents) raised the risk of new disability between 28 percent and 30 percent, depending on the test, the investigators found.

Uncontrolled hypertension (140/90 mmHg or greater while using antihypertensive agents) increased the risk by 29 percent to 35 percent.

With controlled hypertension, the risk for disability was somewhat lower, ranging from 16 percent to 25 percent, but this was not statistically significant.

“Identification of another risk factor for disability, in this case, hypertension, may be considered bad news,” Drs. Merrill F. Elias and Penelope K. Elias, from the University of Maine in Orono, comment in a related editorial.

“However, the study by Hajjar et al also offers good news. A successfully treated cohort of study participants for whom blood pressure was reduced to normal levels on antihypertensive drugs did not show decline in functional abilities compared with normotensive subjects.”

SOURCE: Hypertension, December 2007.

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