“From Apennines to Andes:” Does Body Mass Index Affect the Relationship Between Age and Blood Pressure?

Abstract

See related article, pp 25–33 > … after all those days of travel across that endless plain, he saw before him a chain of mountains which reminded him of the Alps. They were the Andes … > > — Heart Novel , Edmondo De Amicis Even small differences in blood pressure (BP) significantly impact the lifetime risk for cardiovascular disease. In a meta-analysis involving ≈1 million adults with no previous vascular disease enrolled in 61 prospective observational studies, within each decade of age, even minor differences in the usual systolic or diastolic BPs were associated with different risks of mortality for stroke and ischemic heart disease. These age-specific associations were similar in men and women.1 A recent meta-analysis from 18 cohort studies showed a substantially lower lifetime risk of cardiovascular disease in subjects with BP <120/80 mm Hg and low-risk profile than in subjects with higher BP.2 Age is of major importance in determining BP levels, and the age-related rise in BP is primarily responsible for an increase in both incidence and prevalence of hypertension with aging. Some longitudinal surveys of the general population carried out in the past provided an opportunity to explore the relations between changes of BP and age. Studies from industrialized countries confirmed the presence of age-related changes in systolic and diastolic BPs.3–5 A report from 3 different longitudinal Swedish population studies for a total of 1304 men and 1246 women followed for ≤12 years showed that the mean systolic/diastolic BP in untreated subjects increased in men from 138/91 mm Hg at 50 years of age to 159/91 mm Hg at age 79 years and from 123/79 mm Hg at age 38 years to 168/93 mm Hg at age 70 years in women.3 Similar results were obtained from a representative …