PULSE PRESSURE ASSOCIATED WITH PHYSICAL FUNCTION DECLINE AND FRAILTY SYNDROME PROGRESSION

Abstract

Objective: Arterial stiffness and hypertension interacted and related to frailty syndrome. The physical function decline was the dominant component of frailty syndrome. The longitudinal relationships of arterial stiffness and hypertension for physical function decline among elderly population remain ambiguous. We aimed to investigate the associations of arterial stiffness and hypertension for the physical, functional decline in a prospective study. Design and method: A total of 3218 adults aged > = 55 years old from The Healthy Aging Longitudinal Study in Taiwan (HALST) cohort was followed 5 years for evaluating the physical, functional decline, including gait speed, hand grip, the 6-meter walking distance at baseline (2008) and 2nd wave (2013). Artery stiffness were evaluated by the pulse pressure (systolic mines diastolic blood pressure). The physical function decline was defined by the significantly slower gait speed (gait speed because lower more than 0.23 m/sec). Logistic regression was used to evaluate the associations of pulse pressure and hypertension for the slowness of gait speed. Results: Baseline pulse pressure was associated the changes of gait speed (beta = -0.1121, p < .0001). The changes of gait speed between baseline and the followed wave for those with PP < 40 mmHg(group-1,n = 196), 40–60 mmHg(group-2, n = 1874), 60–70 mmHg(group-3,n = 656), 70–80 mmHg(group-4,n = 302) and > = 80 mmHg(group-5,n = 190) were 0.04 ± 0.24 m/sec, 0.00 ± 0.23 m/sec, -0.04 ± 0.42 m/sec, -0.05 ± 0.23 m/sec, and -0.07 ± 0.25 m/sec (p-value for trend < .0001), respectively. The proportion of significant decline in gait speed (-0.23m/sec) was 10.20% for group-1, 17.56% for group-2, 22.87% for group-3, 27.48% for group-4 and 33.68% for group-5 (p-value for trend < 0.0001). Compared to those with PP less than 40 mm Hg (group-1), the odds ratio of physical, functional decline was 4.47(95% confidence intervals: 2.57–7.76) for group-5, 3.34(1.97–5.65) for group-4, 2.61(1.59∼4.29) for group-3 and 1.87(1.16∼3.02) for group-2. The associations remain significant in the model adjusted for age and glucose.We also found higher systolic BP (Systolic BP> = 150 mmHg) has significantly risk for physical function decline (OR = 1.32; 95% CI:1.01∼1.73), compare to normal blood pressure or well controlling BP (SBP: 120∼140 mmHg) Conclusions: Pulse pressure was associated with physical function decline among elderly population. Blood pressure controlling could delay the progression of physical function decline.