title: Blood Pressure Trajectory, Gait Speed, and Outcomes: The Health, Aging, and Body Composition Study.
abstract: The present study aimed to (i) evaluate previous observations that the association of blood pressure (BP) with outcomes varies by gait speed and (ii) evaluate the association of subsequent changes in BP and cardiovascular risk.
  
  
  
  Participants included 2,669 adults aged 70-79 years in the Health, Aging, and Body Composition (Health ABC) study. Gait speed was dichotomized at ≥1.0 m/s over a 20-m test at baseline. BP was measured at baseline, and changes in BP over 5 years were evaluated using (i) population-based trajectory models and (ii) intraindividual mean and slope.
  
  
  
  Over a mean of 10 years, there were 1,366 deaths, 336 first myocardial infarctions, and 295 first strokes. There was a differential pattern of association between baseline systolic BP and diastolic BP and outcomes among brisk and moderate speed walkers. For example, the association between higher diastolic BP and mortality was in the protective direction for moderate speed walkers (hazard ratio = 0.75; 95% confidence interval: 0.63, 0.91) per 10 mmHg higher, whereas it was null in brisk walkers (hazard ratio = 1.05; 95% confidence interval: 0.98, 1.11), p value for interaction .01. The 5-year population-based trajectories did not add important information beyond baseline BP. Individual slopes in both systolic BP and diastolic BP did not appear to have important associations with the outcomes.
  
  
  
  In this study, we found that the overall level of BP was associated with myocardial infarction, stroke, and death, and this association differed by baseline gait speed, whereas changes in BP were not associated with these outcomes.
authors.affiliation: School of Biological and Population Health Sciences, Oregon State University, Corvallis. Michelle.Odden@oregonstate.edu.
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Odden
authors.affiliation: School of Biological and Population Health Sciences, Oregon State University, Corvallis.
authors.forename: Chenkai
authors.initials: C
authors.lastname: Wu
authors.affiliation: Department of Medicine, Kidney Health Research Collaborative, University of California, San Francisco.|Department of Epidemiology and Biostatistics, University of California, San Francisco.|Department of Medicine, San Francisco Veterans Affairs Medical Center, California.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Shlipak
authors.affiliation: Cardiovascular Health Research Unit.|Department of Medicine.|Department of Epidemiology, and.|Department of Health Services, University of Washington, Seattle.|Group Health Research Institute, Group Health Cooperative, Seattle, Washington.
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
authors.affiliation: Kidney Research Institute, Department of Medicine, University of Washington, Seattle, Washington.
authors.forename: Ronit
authors.initials: R
authors.lastname: Katz
authors.affiliation: Internal Medicine and Geriatric Medicine, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina.
authors.forename: William B
authors.initials: WB
authors.lastname: Applegate
authors.affiliation: Geriatric Epidemiology Section, National Institute on Aging, Bethesda, Maryland.
authors.forename: Tamara
authors.initials: T
authors.lastname: Harris
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.affiliation: Department of Medicine, Kidney Health Research Collaborative, University of California, San Francisco.|Department of Medicine, San Francisco Veterans Affairs Medical Center, California.
authors.forename: Carmen A
authors.initials: CA
authors.lastname: Peralta
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D001823:Body Composition / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000401:mortality / Q000503:physiopathology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D008297:Male; D010414:Pennsylvania / Q000453:epidemiology; D011446:Prospective Studies; D018570:Risk Assessment; D013714:Tennessee / Q000453:epidemiology; D000072797:Walking Speed / Q000502:physiology*
keywords: Blood pressure; Epidemiology; Function; Gait speed; Hypertension.