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Association of pulse pressure and mean blood pressure to frailty, sarcopenia, and cognitive dysfunction in elderly outpatients with history of hypertension

Hypertension Research (2024)Cite this article

Abstract

This study aimed to evaluate the relationship between pulse pressure (PP) and sarcopenia, frailty, and cognitive function in elderly patients with hypertension. We evaluated 435 elderly patients with a history of hypertension who visited the frail outpatient clinic between July 2015 and October 2021. Data at the 1-, 2-, and 3-year follow-ups were available for 222, 177, and 164 patients, respectively. Sarcopenia, frailty, and cognitive function, including Mini-Mental State Examination (MMSE) scores, were evaluated. The patients’ mean age was 79.2 ± 6.3 years (male, 34.9%). PP and mean blood pressure (BP) were 60.1 ± 13.6 mmHg and 94.1 ± 13.0 mmHg, respectively. At baseline, lower PP was associated with probable dementia (MMSE score ≤23 points) (OR = 0.960 per 1 mmHg increase; 95% CI, 0.933–0.989; P = 0.006) in the model adjusted for conventional confounding factors and comorbidities, whereas higher PP was associated with low handgrip strength (OR = 1.018 per 1 mmHg increase; 95% CI, 1.001–1.036; P = 0.041). In multivariate-adjusted logistic regression analysis of patients with preserved handgrip strength at baseline, reductions in PP (OR = 0.844; 95% CI, 0.731–0.974; P = 0.020) and mean BP (OR = 0.861; 95% CI, 0.758–0.979; P = 0.022) were significantly associated with the incidence of low handgrip strength at 3 years. In conclusion, a higher PP induced by increased arterial stiffness was associated with lower handgrip strength, whereas a lower PP was associated with probable dementia. Reduced PP was associated with decreased handgrip strength after three years.

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Funding

The authors were supported in part by research grants from the Tokyo Metropolitan Institute for Geriatrics and Gerontology (JI, YT); Research Funding for Longevity Sciences (22-9) from the National Center for Geriatrics and Gerontology (NCGG), Japan (JI, AT); and Ministry of Health, Labour and Welfare, Japan (JPMH21GB1002) (JI, YT).

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Authors and Affiliations

  1. Department of Cardiology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan

    Joji Ishikawa, Ayumi Toba, Shutaro Futami, Yoshihiro Saito & Kazumasa Harada

  2. Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan

    Yoshiaki Tamura & Atsushi Araki

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  1. Joji Ishikawa
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Contributions

J Ishikawa, Y Tamura, and A Araki had full access to all the data in this study. J Ishikawa was responsible for the accuracy of the data analysis. Concept and design: J Ishikawa, Y Tamura, and A. Araki. Data acquisition, analysis, and interpretation: J Ishikawa, Y Tamura, and A. Araki. Drafting of the manuscript: J Ishikawa. Critical revisions: All authors. Statistical analysis: J Ishikawa.

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Correspondence to Joji Ishikawa.

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Ishikawa, J., Toba, A., Futami, S. et al. Association of pulse pressure and mean blood pressure to frailty, sarcopenia, and cognitive dysfunction in elderly outpatients with history of hypertension. Hypertens Res (2024). https://doi.org/10.1038/s41440-024-01684-w

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