title: Blood Pressure and All-Cause Mortality by Level of Cognitive Function in the Elderly: Results From a Population-Based Study in Rural Greece.
abstract: This study aimed to investigate whether the effect of blood pressure (BP) on mortality differs by levels of cognitive function. The associations of brachial systolic BP, diastolic BP, mean arterial pressure (MAP), and pulse pressure with all-cause mortality were prospectively explored (follow-up 7.0±2.2 years) in 660 community-dwelling individuals (≥60 years) using adjusted Cox models, stratified by cognitive impairment (Mini-Mental State Examination [MMSE] <24). No association between brachial BP variables and mortality was shown for the total sample in quartiles analysis; however, MAP in the highest quartile, compared with the second, was associated with mortality (hazard ratio, 1.85; 95% confidence intervals, 1.09-3.12) among cognitively impaired individuals. The fractional-polynomials approach for BP confirmed this finding and further showed, solely in the MMSE <24 subcohort, U-shaped trends of MAP and systolic BP, with increased mortality risk in extremely low or high values; no such pattern was evident for patients with MMSE ≥24. Elderly individuals with cognitive impairment might be more susceptible to the detrimental effects of low and elevated MAP and systolic BP.
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Marios K
authors.initials: MK
authors.lastname: Georgakis
authors.affiliation: Cardiovascular Prevention and Research Unit, Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Athanasios D
authors.initials: AD
authors.lastname: Protogerou
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Eleni I
authors.initials: EI
authors.lastname: Kalogirou
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Kontogeorgi
authors.affiliation: Health Centre of Velestino, Ahillopouleio General Hospital of Volos, Velestino, Volos, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Pagonari
authors.affiliation: Health Centre of Velestino, Ahillopouleio General Hospital of Volos, Velestino, Volos, Greece.
authors.forename: Fani
authors.initials: F
authors.lastname: Sarigianni
authors.affiliation: Second Department of Neurology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Chaidari, Athens, Greece.
authors.forename: Sokratis G
authors.initials: SG
authors.lastname: Papageorgiou
authors.affiliation: First Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kapaki
authors.affiliation: First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Papageorgiou
authors.affiliation: First Department of Cardiology, Hippokrateion Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tousoulis
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.|First Department of Cardiology, Hippokrateion Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Eleni Th
authors.initials: ET
authors.lastname: Petridou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001795:Blood Pressure Determination; D002423:Cause of Death; D003072:Cognition Disorders / Q000150:complications*; D005260:Female; D006115:Greece; D006801:Humans; D006973:Hypertension / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012424:Rural Population