TY - JOUR T1 - Blood Pressure and Mortality: Joint Effect of Blood Pressure Measures JF - Journal of Clinical Cardiology and Cardiovascular Therapy Y1 - 2020 A1 - Jung K Kim A1 - Eileen M. Crimmins KW - diastolic blood pressure KW - Mortality KW - pulse pressure KW - Systolic blood pressure AB - We examine how combinations of systolic and diastolic blood pressure levels and pulse pressure levels predicted mortality risk. Respondents are those aged over 50 from the Health and Retirement Study (N=10,366) who provided blood pressure measures in 2006/2008. Systolic and diastolic blood pressures were measured three times; and we averaged the three readings. Pulse pressure was calculated as systolic minus diastolic blood pressure. Seven combinations of systolic and diastolic blood pressure (low/normal/high of each) and three levels of pulse pressure (low/normal/high) were used to categorize blood pressure. Over 1 to 10 years of follow-up (average follow-up time of 7.8 years), 2,820 respondents died after blood pressure measurement in 2006/2008. Potential covariates including age, gender, education, BMI, total cholesterol, HbA1c, antihypertensive medication intake and lifetime-smoking pack years were adjusted in Cox proportional hazard models and survival curves. The blood pressure subgroup with low systolic blood pressure (<90 mmHg) and low diastolic blood pressure (< 60 mmHg) had the highest relative risk of mortality (HR=2.34, 95% CI: 1.45-3.80), followed by those with normal systolic blood pressure but low diastolic blood pressure (HR=1.45, 95% CI: 1.17-1.81) among those with cardiovascular conditions at baseline. For those without cardiovascular conditions at baseline, low blood pressure, either systolic or diastolic, was not related to mortality. Those with high levels of both systolic and diastolic blood pressure had a higher risk of mortality than those with both blood pressures normal but no other subgroups with low blood pressure differed from normal/normal in predicting mortality. Pulse pressure did not predict mortality. How high and low blood pressures are related to mortality needs to be examined by jointly looking at systolic and diastolic blood pressure. VL - 2 IS - 1.1009 ER - TY - JOUR T1 - Becoming centenarians: disease and functioning trajectories of older US Adults as they survive to 100. JF - J Gerontol A Biol Sci Med Sci Y1 - 2015 A1 - Jennifer A Ailshire A1 - Hiram Beltrán-Sánchez A1 - Eileen M. Crimmins KW - Activities of Daily Living KW - Aged, 80 and over KW - Aging KW - Chronic disease KW - Cognition KW - Disability Evaluation KW - Educational Status KW - Female KW - Geriatric Assessment KW - Health Status KW - Health Surveys KW - Humans KW - Longevity KW - Longitudinal Studies KW - Male KW - Marital Status KW - Prospective Studies KW - Sex Factors KW - United States AB -

BACKGROUND: Little is known about the health and functioning of individuals who become centenarians in the years prior to reaching age 100. We examined long-term trajectories of disease, disability, and cognitive function in a sample of U.S. centenarians to determine how their aging experience differs from their nonsurviving cohort counterparts, and if there is heterogeneity in the aging experience of centenarians.

METHODS: Data are from the 1993-2010 waves of the nationally representative Health and Retirement Study. Among those who had the potential to become centenarians, we identified 1,045 respondents who died before reaching age 100 and 96 who survived to their 100th birthday. Respondents, or their proxies, reported on diagnosis of six major diseases (hypertension, heart disease, lung disease, stroke, cancer, and diabetes), limitations in activities of daily living, and cognitive function.

RESULTS: As they age to 100, centenarians are generally healthier than nonsurviving members of their cohort, and a number of individuals who become centenarians reach 100 with no self-reported diseases or functional impairments. About 23% of centenarians reached age 100 with no major chronic disease and approximately the same number had no disability (18%). Over half (55%) reached 100 without cognitive impairment. Disease and functioning trajectories of centenarians differ by sex, education, and marital status.

CONCLUSIONS: While some centenarians have poor health and functioning upon reaching age 100, others are able to achieve exceptional longevity in relatively good health and without loss of functioning. This study underscores the importance of examining variation in the growing centenarian population.

PB - 70 VL - 70 UR - http://biomedgerontology.oxfordjournals.org/content/70/2/193.abstract IS - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25136001?dopt=Abstract ER -