Author/Authors :
Benetos، نويسنده , , Athanase and Gautier، نويسنده , , Sylvie and Labat، نويسنده , , Carlos and Salvi، نويسنده , , Paolo and Valbusa، نويسنده , , Filippo and Marino، نويسنده , , Francesca and Toulza، نويسنده , , Olivier and Agnoletti، نويسنده , , Davide and Zamboni، نويسنده , , Mauro and Dubail، نويسنده , , Delphine and Manckoundia، نويسنده , , Patrick and Rolland، نويسنده , , Yves and Hanon، نويسنده , , Olivier and Perret-Guillaume، نويسنده , , Christine and Lacolley، نويسنده , , Patrick and Safar، نويسنده , , Michel E. and Guillemin، نويسنده , , Francis، نويسنده ,
Abstract :
Objectives
m of the longitudinal PARTAGE study was to determine the predictive value of blood pressure (BP) and pulse pressure amplification, a marker of arterial function, for overall mortality (primary endpoint) and major cardiovascular (CV) events, in subjects older than 80 years of age living in a nursing home.
ound
ment of pulse indexes may be important in the evaluation of the CV risk in very elderly frail subjects.
s
l of 1,126 subjects (874 women) who were living in French and Italian nursing homes were enrolled (mean age, 88 ± 5 years). Central (carotid) to peripheral (brachial) pulse pressure amplification (PPA) was calculated with the help of an arterial tonometer. Clinical and 3-day self-measurements of BP were conducted.
s
the 2-year follow-up, 247 subjects died, and 228 experienced major CV events. The PPA was a predictor of total mortality and major CV events in this population. A 10% increase in PPA was associated with a 24% (p < 0.0003) decrease in total mortality and a 17% (p < 0.01) decrease in major CV events. Systolic BP, diastolic BP, or pulse pressure were either not associated or inversely correlated with total mortality and major CV events.
sions
y elderly individuals living in nursing homes, low PPA from central to peripheral arteries strongly predicts mortality and adverse effects. Assessment of this parameter could help in risk estimation and improve diagnostic and therapeutic strategies in very old, polymedicated persons. In contrast, high BP is not associated with higher risk of mortality or major CV events in this population. (Predictive Values of Blood Pressure and Arterial Stiffness in Institutionalized Very Aged Population [PARTAGE]; NCT00901355)
Keywords :
Blood pressure , mortality , Elderly , nursing home , Pulse pressure amplification