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High blood pressure accelerates gait slowing in well-functioning older adults over 18-years of follow-up.
Tuesday,2012-11-06 12:25 America/Los_Angeles — eenright
| Title | High blood pressure accelerates gait slowing in well-functioning older adults over 18-years of follow-up. |
| Publication Type | Journal Article |
| Year of Publication | 2011 |
| Authors | Rosano, C, Longstreth, WT, Boudreau, R, Taylor, CA, Du, Y, Kuller, LH, Newman, AB |
| Journal | J Am Geriatr Soc |
| Volume | 59 |
| Issue | 3 |
| Pagination | 390-7 |
| Date Published | 2011 Mar |
| ISSN | 1532-5415 |
| Keywords | Aged, Antihypertensive Agents, Comorbidity, Female, Follow-Up Studies, Gait, Geriatric Assessment, Humans, Hypertension, Longitudinal Studies, Magnetic Resonance Imaging, Male, Risk Factors, Statistics, Nonparametric |
| Abstract | <p><b>OBJECTIVES: </b>To examine whether the association between hypertension and decline in gait speed is significant in well-functioning older adults and whether other health-related factors, such as brain, kidney, and heart function, can explain it.</p><p><b>DESIGN: </b>Longitudinal cohort study.</p><p><b>SETTING: </b>Cardiovascular Health Study.</p><p><b>PARTICIPANTS: </b>Of 2,733 potential participants with a brain magnetic resonance imaging (MRI) scan, measures of mobility and systolic blood pressure (BP), no self-reported disability in 1992 to 1994 (baseline), and with at least 1 follow-up gait speed measurement through 1997 to 1999, 643 (aged 73.6, 57% female, 15% black) who had received a second MRI in 1997 to 1999 and an additional gait speed measure in 2005 to 2006 were included.</p><p><b>MEASUREMENTS: </b>Mixed models with random slopes and intercepts were adjusted for age, race, and sex. Main explanatory factors included white matter hyperintensity progression, baseline cystatin-C, and left cardiac ventricular mass. Incidence of stroke and dementia, BP trajectories, and intake of antihypertensive medications during follow-up were tested as other potential explanatory factors.</p><p><b>RESULTS: </b>Higher systolic BP was associated with faster rate of gait speed decline in this selected group of 643 participants, and results were similar in the parent cohort (N = 2,733). Participants with high BP (n = 293) had a significantly faster rate of gait speed decline than those with baseline BP less than 140/90 mmHg and no history of hypertension (n = 350). Rates were similar for those with history of hypertension who were uncontrolled (n = 110) or controlled (n = 87) at baseline and for those who were newly diagnosed (n = 96) at baseline. Adjustment for explanatory factors or for other covariates (education, prevalent cardiovascular disease, physical activity, vision, mood, cognition, muscle strength, body mass index, osteoporosis) did not change the results.</p><p><b>CONCLUSION: </b>High BP accelerates gait slowing in well-functioning older adults over a long period of time, even for those who control their BP or develop hypertension later in life. Health-related measurements did not explain these associations. Future studies to investigate the mechanisms linking hypertension to slowing gait in older adults are warranted.</p> |
| DOI | 10.1111/j.1532-5415.2010.03282.x |
| Alternate Journal | J Am Geriatr Soc |
| PubMed ID | 21391929 |
| PubMed Central ID | PMC3637929 |
| Grant List | P30 AG024827 / AG / NIA NIH HHS / United States UL1 TR000005 / TR / NCATS NIH HHS / United States N01-HC-80007 / HC / NHLBI NIH HHS / United States N01-HC-85085 / HC / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States R01 AG029232 / AG / NIA NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States |