title: Relation of pulse pressure to long-distance gait speed in community-dwelling older adults: findings from the LIFE-P study.
abstract: BACKGROUND
  Reduced gait speed is associated with falls, late-life disability, hospitalization/institutionalization and cardiovascular morbidity and mortality. Aging is also accompanied by a widening of pulse pressure (PP) that contributes to ventricular-vascular uncoupling. The purpose of this study was to test the hypothesis that PP is associated with long-distance gait speed in community-dwelling older adults in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) study.
  
  
  METHODS
  Brachial blood pressure and 400-meter gait speed (average speed maintained over a 400-meter walk at "usual" pace) were assessed in 424 older adults between the ages of 70-89 yrs at risk for mobility disability (mean age=77 yrs; 31% male). PP was calculated as systolic blood pressure (BP) - diastolic BP.
  
  
  RESULTS
  Patients with a history of heart failure and stroke (n=42) were excluded leaving 382 participants for final analysis. When categorized into tertiles of PP, participants within the highest PP tertile had significantly slower gait speed than those within the lowest PP tertile (p<0.05). Following stepwise multiple regression, PP was significantly and inversely associated with 400-meter gait speed (p<0.05). Other significant predictors of gait speed included: handgrip strength, body weight, age and history of diabetes mellitus (p<0.05). Mean arterial pressure, systolic BP and diastolic BP were not predictors of gait speed.
  
  
  CONCLUSIONS
  Pulse pressure is associated long-distance gait speed in community-dwelling older adults. Vascular senescence and altered ventricular-vascular coupling may be associated with the deterioration of mobility and physical function in older adults.
authors.affiliation: Department of Exercise Science, Human Performance Laboratory, Syracuse University, Syracuse, New York, United States of America. ksheffer@syr.edu
authors.forename: Kevin S
authors.initials: KS
authors.lastname: Heffernan
authors.forename: Todd M
authors.initials: TM
authors.lastname: Manini
authors.forename: Fang-Chi
authors.initials: FC
authors.lastname: Hsu
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Nicklas
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Kritchevsky
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.forename: Kim
authors.initials: K
authors.lastname: Sutton-Tyrrell
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Church
authors.forename: William L
authors.initials: WL
authors.lastname: Haskell
authors.forename: Roger A
authors.initials: RA
authors.lastname: Fielding
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D015444:Exercise; D005260:Female; D005684:Gait / Q000502:physiology*; D006339:Heart Rate; D006801:Humans; D008019:Life Style; D008297:Male; D012372:ROC Curve; D012044:Regression Analysis; D016138:Walking