Abstract
This study aimed to evaluate the relationship between pulse pressure (PP) and sarcopenia, frailty, and cognitive function in elderly patients with hypertension. We evaluated 435 elderly patients with a history of hypertension who visited the frail outpatient clinic between July 2015 and October 2021. Data at the 1-, 2-, and 3-year follow-ups were available for 222, 177, and 164 patients, respectively. Sarcopenia, frailty, and cognitive function, including Mini-Mental State Examination (MMSE) scores, were evaluated. The patients’ mean age was 79.2 ± 6.3 years (male, 34.9%). PP and mean blood pressure (BP) were 60.1 ± 13.6 mmHg and 94.1 ± 13.0 mmHg, respectively. At baseline, lower PP was associated with probable dementia (MMSE score ≤23 points) (OR = 0.960 per 1 mmHg increase; 95% CI, 0.933–0.989; P = 0.006) in the model adjusted for conventional confounding factors and comorbidities, whereas higher PP was associated with low handgrip strength (OR = 1.018 per 1 mmHg increase; 95% CI, 1.001–1.036; P = 0.041). In multivariate-adjusted logistic regression analysis of patients with preserved handgrip strength at baseline, reductions in PP (OR = 0.844; 95% CI, 0.731–0.974; P = 0.020) and mean BP (OR = 0.861; 95% CI, 0.758–0.979; P = 0.022) were significantly associated with the incidence of low handgrip strength at 3 years. In conclusion, a higher PP induced by increased arterial stiffness was associated with lower handgrip strength, whereas a lower PP was associated with probable dementia. Reduced PP was associated with decreased handgrip strength after three years.
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Funding
The authors were supported in part by research grants from the Tokyo Metropolitan Institute for Geriatrics and Gerontology (JI, YT); Research Funding for Longevity Sciences (22-9) from the National Center for Geriatrics and Gerontology (NCGG), Japan (JI, AT); and Ministry of Health, Labour and Welfare, Japan (JPMH21GB1002) (JI, YT).
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J Ishikawa, Y Tamura, and A Araki had full access to all the data in this study. J Ishikawa was responsible for the accuracy of the data analysis. Concept and design: J Ishikawa, Y Tamura, and A. Araki. Data acquisition, analysis, and interpretation: J Ishikawa, Y Tamura, and A. Araki. Drafting of the manuscript: J Ishikawa. Critical revisions: All authors. Statistical analysis: J Ishikawa.
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Ishikawa, J., Toba, A., Futami, S. et al. Association of pulse pressure and mean blood pressure to frailty, sarcopenia, and cognitive dysfunction in elderly outpatients with history of hypertension. Hypertens Res (2024). https://doi.org/10.1038/s41440-024-01684-w
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DOI: https://doi.org/10.1038/s41440-024-01684-w
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