title: The association of blood pressure and mortality differs by self-reported walking speed in older Latinos.
abstract: BACKGROUND
  In some older adults, higher blood pressure (BP) is associated with a lower risk of mortality. We hypothesized that higher BP would be associated with greater mortality in high-functioning elders and lower mortality in elders with lower functional status.
  
  
  METHODS
  Participants were 1,562 Latino adults aged 60-101 years in the Sacramento Area Latino Study on Aging. Functional status was measured by self-reported walking speed, and BP was measured by automatic sphygmomanometer. Death information was determined from vital statistics records.
  
  
  RESULTS
  There were 442 deaths from 1998 to 2010; 53% were cardiovascular. Mean BP levels (mmHg) varied across fast, medium, and slow walkers: 136, 139, and 140 mmHg (systolic), p = .02 and 75, 76, and 77 mmHg (diastolic), p = .08, respectively. The relationship between systolic BP and mortality varied by self-reported walking speed: The adjusted hazard ratio for mortality in slow walkers was 0.96 per 10 mmHg higher systolic BP (95% confidence interval: 0.89, 1.02) and 1.29 (95% confidence interval: 1.08, 1.55) in fast walkers (p value for interaction <.001). We found a similar pattern for diastolic BP, although the interaction did not reach statistical significance; the adjusted hazard ratio per 10 mmHg higher diastolic BP was 0.89 (95% confidence interval: 0.78, 1.02) in slow walkers and 1.20 (95% confidence interval: 0.82, 1.76) in fast walkers (p value for interaction = .06).
  
  
  CONCLUSIONS
  In high-functioning older adults, elevated systolic BP is a risk factor for all-cause mortality. If confirmed in other studies, the assessment of functional status may help to identify persons who are most at-risk for adverse outcomes related to high BP.
authors.affiliation: Epidemiology, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA. michelle.odden@oregonstate.edu
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Odden
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Covinsky
authors.forename: John M
authors.initials: JM
authors.lastname: Neuhaus
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Mayeda
authors.forename: Carmen A
authors.initials: CA
authors.lastname: Peralta
authors.forename: Mary N
authors.initials: MN
authors.lastname: Haan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001794:Blood Pressure; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D016330:Frail Elderly; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D009026:Mortality; D016016:Proportional Hazards Models; D012307:Risk Factors; D057566:Self Report; D016138:Walking