目的:这项研究检查了老年男性晚年体力表现的变化是否与血压(BP)的同期变化有关。
方法:超过7年的前瞻性队列研究。
方法:身体表现(步态速度,握力,在男性骨质疏松性骨折研究(MrOS)中,对3,135名年龄≥65岁的男性进行了评估,并在基线和至少一次随访(7年或9年)时进行了临床测量的BP。
方法:具有标准化点估计(β[95%CI])的多变量模型的广义估计方程分析描述了身体表现与参与者总体BP变化之间的纵向关联,并按基线心血管疾病(CVD)分层,抗高血压药物使用(无,≥1),和入学年龄(<75岁;≥75岁)。
结果:总体而言,在步态速度和收缩压(SBP)(0.74[0.22,1.26])与握力(0.35[0.04,0.65])或步态速度(0.55[0.24,0.85])和舒张压(DBP)的每个增量之间发现了正相关(z-得分单位).随着时间的推移,更好的握力和椅子支架性能与1.83[0.74,2.91]和3.47[0.20,6.74]mmHg更高的SBP相关,分别在基线患有CVD的男性中(两者相互作用P<0.05)。在没有心血管疾病的男性中,步态速度增加与较高的SBP相关(0.76[0.21,1.32]),抗高血压药物非使用者(0.96[0.30,1.62]),年龄<75岁(0.73[0.05,1.41])和≥75岁(0.76[0.06,1.47])。类似的积极,但在患有CVD的男性中,观察到DBP与握力的适度关联,抗高血压药物非使用者,年龄<75岁,没有心血管疾病的男性的步态速度,年龄<75岁,无论使用何种抗高血压药物。
结论:在老年男性中,更好的物理性能与更高的BP纵向相关。这些看似矛盾的发现的机制和含义,它似乎被CVD状态改变了,抗高血压药物的使用,和年龄,需要进一步调查。
OBJECTIVE: This study examined whether changes in late-life physical performance are associated with contemporaneous changes in blood pressure (BP) in older men.
METHODS: prospective cohort study over 7 years.
METHODS: Physical performance (gait speed, grip strength, chair stand performance) and clinic-measured BP at baseline and at least one follow-up (year 7 or 9) were assessed in 3,135 men aged ≥65 y enrolled in the Osteoporotic Fractures in Men Study (MrOS).
METHODS: Generalized estimating equation analysis of multivariable models with standardized point estimates (β [95% CI]) described longitudinal associations between physical performance and BP changes in participants overall, and stratified by baseline cardiovascular disease (CVD), antihypertensive medication use (none, ≥1), and enrollment age (<75 years; ≥75 years).
RESULTS: Overall, positive associations (z-score units) were found between each increment increase in gait speed and systolic (SBP) (0.74 [0.22, 1.26]) and grip strength (0.35 [0.04, 0.65]) or gait speed (0.55 [0.24, 0.85]) with diastolic (DBP). Better grip strength and chair stand performance over time were associated with 1.83 [0.74, 2.91] and 3.47 [0.20, 6.74] mmHg higher SBP, respectively in men with CVD at baseline (both interaction P < .05). Gait speed increases were associated with higher SBP in men without CVD (0.76 [0.21, 1.32]), antihypertensive medication non-users (0.96 [0.30, 1.62]), aged <75 years (0.73 [0.05, 1.41]) and ≥75 years (0.76 [0.06, 1.47]). Similar positive, but modest associations for DBP were observed with grip strength in men with CVD, antihypertensive medication non-users, and aged <75 years, and with gait speed in men without CVD, aged <75 years, and irrespective of antihypertensive medication use.
CONCLUSIONS: In older men, better physical performance is longitudinally associated with higher BP. Mechanisms and implications of these seemingly paradoxical findings, which appears to be modified by CVD status, antihypertensive medication use, and age, requires further investigation.