Abstract
Objective: The elderly population represents several medical challenges, particularly in the management of hypertension. However, the ideal blood pressure (BP) goal for very old people is still unclear. Especially, benefit of strict BP control for very old people is controversial. This is a serious issue in frail older people considering the adverse outcome. The purpose of this study is to investigate the association of BP level with frailty indicators among 70 and 80-year-old community dwelling Japanese. Design and Method: Community-dwelling older men aged 70 ± 1 (n = 457) and 80 ± 1 (n = 479) years participated in the invitation survey at the community centers; Septuagenarians, Octogenarians and Nonagenarians Investigation with Centenarians (SONIC) study. We interviewed medical histories and medications. BP, grip strength and 8-feet gait speed was examined on site. Mean differences of the grip strength and gait speed based on the BP level were evaluated using one-way ANOVA. Results: Among the participants with antihypertensive treatment, there was the significant difference of the grip strength between low level of diastolic BP (DBP): < 70 mmHg (24.7 kg) and other levels of DBP (70–80 mmHg: 27 kg, 80–90 mmHg: 27.4 kg, 90–100 mmHg: 29 kg) in men age around 80 by the multiple pairwise comparisons. The difference of the grip strength was not significant among participants without antihypertensive treatment nor among participants age around 70 regardless of the antihypertensive treatment. About systolic BP, the tendency of result was similar to DBP. No significant difference among any BP levels was observed for the gait speed. Conclusions: We found that the low DBP (< 70 mmHg) men participants age around 80 with antihypertensive treatment had significantly weak grip strength. The causal relationship should be clarified whether the weak grip strength is caused by excessive reduction of BP.
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