title: Blood pressure in relation to age and frailty.
abstract: OBJECTIVE
  On average, systolic blood pressure (SBP) rises with age, while diastolic blood pressure (DBP) increases to age 50 and then declines. As elevated blood pressure is associated with cardiovascular disease and mortality, it also might be linked to frailty. We assessed the association between blood pressure, age, and frailty in a representative population-based cohort.
  
  
  METHODS
  Individuals from the second clinical examination of the Canadian Study of Health and Aging (n = 2305, all 70+ years) were separated into four groups: history of hypertension ± antihypertensive medication, and no history of hypertension ± antihypertensive medication. Frailty was quantified as deficits accumulated in a frailty index (FI).
  
  
  RESULTS
  SBP and DBP changed little in relation to age, except in untreated hypertension, where SBP declined in individuals >85 years. In contrast, SBP declined in all groups up to an FI of 0.55, and then rose sharply. DBP changed little in relation to FI. The slope of the line relating FI and age was highest in untreated individuals without a history of hypertension, indicating the highest physiological reserve.
  
  
  CONCLUSIONS
  SBP declined as frailty increased in older adults, except at the highest FI levels. SBP and age had little or no relationship.
authors.affiliation: Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, NS.
authors.forename: Michael R H
authors.initials: MR
authors.lastname: Rockwood
authors.forename: Susan E
authors.initials: SE
authors.lastname: Howlett