title: Blood pressure and all-cause mortality: a prospective study of nursing home residents.
abstract: to explore the natural course of blood pressure development and its relation to mortality in a nursing home cohort.
  
  
  
  a cohort of 406 nursing home residents in south east Sweden was followed prospectively for 30 months. Participants were divided into four groups based on systolic blood pressure (SBP) at baseline. Data were analysed using a Cox regression model with all-cause mortality as the outcome measurement; paired Student t-tests were used to evaluate blood pressure development over time.
  
  
  
  during follow-up, 174 (43%) people died. Participants with SBP < 120 mmHg had a hazard ratio for mortality of 1.56 (95% confidence interval, 1.08-2.27) compared with those with SBP 120-139 mmHg, adjusted for age and sex. Risk of malnutrition or present malnutrition was most common in participants with SBP < 120 mmHg; risk of malnutrition or present malnutrition estimated using the Mini Nutritional Assessment was found in 78 (71%). The levels of SBP decreased over time independent of changes in anti-hypertensive medication.
  
  
  
  in this cohort of nursing home residents, low SBP was associated with increased all-cause mortality. SBP decreased over time; this was not associated with altered anti-hypertensive treatment. The clinical implication from this study is that there is a need for systematic drug reviews in elderly persons in nursing homes, paying special attention to those with low SBP.
authors: Department of Medical and Health Sciences, Primary care, Linköping University, Linköping SE-581 83, Sweden.
authors: Karin
authors: K
authors: Rådholm
authors: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors: Karin
authors: K
authors: Festin
authors: Division of Community Medicine, Primary Care, Department of Medicine and Health Sciences, Faculty of Health Sciences, Department of Local Care Central, County Council of Östergötland, Linköping University, Linköping, Sweden.
authors: Magnus
authors: M
authors: Falk
authors: Department of Clinical Sciences, Lund University Malmö, Sweden.
authors: Patrik
authors: P
authors: Midlöv
authors: Department of Clinical Sciences, Lund University Malmö, Sweden.
authors: Sigvard
authors: S
authors: Mölstad
authors: Department of Medical and Health Sciences, Primary care, Linköping University, Linköping SE-581 83, Sweden.
authors: Carl Johan
authors: CJ
authors: Östgren
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002423:Cause of Death; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006707:Homes for the Aged; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality* / Q000503:physiopathology; D007022:Hypotension / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality* / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D044342:Malnutrition / Q000401:mortality / Q000503:physiopathology; D009735:Nursing Homes; D015596:Nutrition Assessment; D009752:Nutritional Status; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D015431:Weight Loss
chemical_list: D000959:Antihypertensive Agents
keywords: all-cause mortality; hypertension; hypotension; nursing home; older people; prospective study