title: Relationship between high blood pressure and cardiovascular outcomes in elderly frail patients: A systematic review and meta-analysis.
abstract: Prior studies have suggested that lower blood pressure increases the mortality risk in the elderly. This study examines the relationship between change in blood pressure and overall mortality in frail elderly patients. Medline, PubMed, Cochrane, and Google Scholar databases were searched until April 2, 2015 using search terms: frail/frailty, elderly/aged, blood pressure, hypertension, cardiovascular events, and mortality/prognosis. Two-arm prospective and retrospective studies that investigated BP and the incidence of mortality in frail elderly patients were included. We found that the chance of mortality decreased with increasing systolic blood pressure (SBP) (pooled HR = 0.870, 95% CI = 0.776-0.976, P = 0.018) and diastolic blood pressure (DBP) (pooled HR = 0.837, 95% CI = 0.77-0.911, P < 0.001). Pulse pressure was not associated with mortality risk (pooled HR = 0.949, 95% CI = 0.897-1.004, P < 0.071). In elderly frailty patients, hypertension has a protective effect in lowering risk of overall mortality. Accurate identification of such elderly population is necessary for optimizing health care.
authors.affiliation: Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China. Electronic address: yuji5832@163.com.
authors.forename: Xiu-E
authors.initials: XE
authors.lastname: Zhang
authors.affiliation: Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China.
authors.forename: Bei
authors.initials: B
authors.lastname: Cheng
authors.affiliation: Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Wang
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000628:therapy; D016330:Frail Elderly; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D015994:Incidence; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents
keywords: Blood pressure; Cardiovascular events; Elderly; Frail; Hypertension; Mortality