title: High blood pressure in middle age is associated with a future decline in activities of daily living. NIPPON DATA80.
abstract: Although several studies have reported on the relation between high blood pressure (BP) and impaired activities of daily living (ADL), only a few studies have reported on the relation of high BP in middle-aged subjects with future impaired ADL. Furthermore, no studies reported an excess impaired ADL due to non-normal BP. Using ADL 1999 data, we compared data from NIPPON DATA80 survivors without impaired ADL (N=1816) with those with impaired ADL (N=75) using baseline BP information collected in 1980. We analysed participants who were aged 47-59 years at baseline. Multiple adjusted logistic regression analyses were used to estimate the risk of impaired ADL, according to baseline BP categories using Joint National Committee 7 guidelines (normal BP, prehypertension, stage 1 hypertension (HT) and stage 2 HT). Subjects who used antihypertensive medications were classified as having stage 2 HT. We calculated excess impaired ADL due to non-normal BP. Compared with normal BP categories, the adjusted odds ratio (OR) and 95% confidence interval (CI) of having impaired ADL was higher in subjects with prehypertension (OR=1.50, 95% CI: 0.55-4.09), stage 1 HT (OR=1.56, 95% CI: 0.56-4.32) and stage 2 HT (OR=2.96, 95% CI: 1.09-8.05). Non-normal BP explained 45% (33.7/75) of impaired ADL. A positive relation of BP categories with the composite end point of mortality and impaired ADL was also observed. In conclusion, controlling BP in middle age may prevent deaths and future ADL decline.
authors.affiliation: Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aobaku, Sendai 980-8575, Japan. hozawa-thk@umin.ac.jp
authors.forename: A
authors.initials: A
authors.lastname: Hozawa
authors.forename: T
authors.initials: T
authors.lastname: Okamura
authors.forename: Y
authors.initials: Y
authors.lastname: Murakami
authors.forename: T
authors.initials: T
authors.lastname: Kadowaki
authors.forename: N
authors.initials: N
authors.lastname: Okuda
authors.forename: N
authors.initials: N
authors.lastname: Takashima
authors.forename: T
authors.initials: T
authors.lastname: Hayakawa
authors.forename: Y
authors.initials: Y
authors.lastname: Kita
authors.forename: K
authors.initials: K
authors.lastname: Miura
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.forename: A
authors.initials: A
authors.lastname: Okayama
authors.forename: H
authors.initials: H
authors.lastname: Ueshima
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index