Todd, OM orcid.org/0000-0001-7212-8095, Wilkinson, C orcid.org/0000-0003-0748-0150, Hale, M et al. (8 more authors) (2019) Is the association between blood pressure and mortality in older adults different with frailty? A systematic review and meta-analysis. Age and Ageing, 48 (5). afz072. pp. 627-635. ISSN 0002-0729
Abstract
Objective:
To investigate whether the association between blood pressure and clinical outcomes is different in older adults with and without frailty, using observational studies.
Methods:
MEDLINE, EMBASE, and CINAHL were searched from 1st January 2000 to 13th June 2018. Prospero CRD42017081635. We included all observational studies reporting clinical outcomes in older adults with an average age over 65 years living in the community with and without treatment that measured blood pressure and frailty using validated methods. Two independent reviewers evaluated study quality and risk of bias using the ROBANS tool. We used generic inverse variance modelling to pool risks of all-cause mortality adjusted for age and sex.
Results:
Nine observational studies involving 21,906 older adults were included, comparing all-cause mortality over a mean of six years. Fixed effects meta-analysis of six studies demonstrated that in people with frailty, there was no mortality difference associated with systolic blood pressure <140 mm Hg compared to systolic blood pressure >140 mm Hg (HR 1.02, 95% CI 0.90 to 1.16). In the absence of frailty, systolic blood pressure <140 mm Hg was associated with lower risk of death compared to systolic blood pressure >140 mm Hg (HR 0.86, 95% CI 0.77 to 0.96).
Conclusions:
Evidence from observational studies demonstrates no mortality difference for older people with frailty whose systolic blood pressure is <140 mm Hg, compared to those with a systolic blood pressure >140 mm Hg. Current evidence fails to capture the complexities of blood pressure measurement, and the association with non-fatal outcomes.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019, The Author(s). Published by Oxford University Press on behalf of the British Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
Keywords: | hypertension; antihypertensive; older people; ageing; frail; systematic review |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Clinical & Population Science Dept (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Elderly Care and Rehabilitation (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 17 Apr 2019 15:12 |
Last Modified: | 30 May 2023 22:24 |
Status: | Published |
Publisher: | Oxford University Press |
Identification Number: | 10.1093/ageing/afz072 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:145118 |