Association of Systolic and Diastolic Blood Pressure With All-Cause Mortality Among Community-Dwelling Older Adults: A Prospective Observational Study.

Objectives: To assess the association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with mortality among older adults in Singapore.

Methods: Association of SBP and DBP measured in 2009 for 4443 older adults (69.5±7.4 years; 60-97 years) participating in a nationally representative study with mortality risk through end-December 2015 was assessed using Cox regression.

Results: Higher mortality risk was observed at the lower and upper extremes of SBP and DBP. With SBP of 100-119 mmHg as the reference, multivariable mortality hazard ratios [HRs (95% confidence interval)] were SBP <100 mmHg: 2.41 (1.23-4.72); SBP 160-179 mmHg: 1.51 (1.02-2.22); and SBP ≥180 mmHg: 1.78 (1.12-2.81). With DBP of 70-79 mmHg as the reference, HRs were DBP <50 mmHg: 2.41 (1.28-4.54) and DBP ≥110 mmHg: 2.16 (1.09-4.31). Discussion: Management of high blood pressure among older adults will likely reduce their mortality risk. However, the association of excessively low SBP and DBP values with mortality risk needs further evaluation.