BACKGROUND:The relationship between systolic blood pressure (SBP) and longevity is not fully understood. We aimed to determine which SBP levels in women ≥65 years of age with or without blood pressure medication were associated with the highest probability of surviving to 90 years of age.METHODS:The study population consisted of 16570 participants enrolled in the Women’s Health Initiative who were eligible to survive to 90 years of age by February 28, 2020, without a history of cardiovascular disease, diabetes, or cancer. Blood pressure was measured at baseline (1993 through 1998) and then annually through 2005. The outcome was defined as survival to 90 years of age with follow-up. Absolute probabilities of surviving to 90 years of age were estimated for all combinations of SBP and age using generalized additive logistic regression modeling. The SBP that maximized survival was estimated for each age, and a 95% CI was generated.RESULTS:During a median follow-up of 19.8 years, 9723 of 16 570 women (59%) survived to 90 years of age. Women with an SBP between 110 and 130 mm Hg at attained ages of 65, 70, 75, and 80 years had a 38% (95% CI, 34%–48%), 54% (52%–56%), 66% (64%–67%), or 75% (73%–78%) absolute probability to survive to 90 years of age, respectively. The probability of surviving to 90 years of age was lower for greater SBP levels. Women at the attained age of 80 years with 0%, 20%, 40%, 60%, 80%, or 100% time in therapeutic range (defined as an SBP between 110 and 130 mm Hg) had a 66% (64%–69%), 68% (67%–70%), 71% (69%–72%), 73% (71%–74%), 75% (72%–77%), or 77% (74%–79%) absolute survival probability to 90 years of age.CONCLUSIONS:For women >65 years of age with low cardiovascular disease and other chronic disease risk, an SBP level <130 mm Hg was found to be associated with longevity. These findings reinforce current guidelines targeting an SBP target <130 mm Hg in older women.

中文翻译：

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收缩压和高龄生存：妇女健康倡议的结果

背景：收缩压（SBP）与寿命之间的关系尚不完全清楚。我们的目的是确定 65 岁以上女性使用或不使用血压药物时哪些 SBP 水平与存活至 90 岁的最高概率相关。 方法：研究人群由参加女性健康倡议的 16570 名参与者组成，他们到 2020 年 2 月 28 日，有资格生存到 90 岁，并且没有心血管疾病、糖尿病或癌症病史。在基线（1993 年至 1998 年）测量血压，然后到 2005 年每年测量一次。结果定义为随访至 90 岁的存活率。使用广义加性逻辑回归模型估计 SBP 和年龄的所有组合的存活至 90 岁的绝对概率。对每个年龄的生存率最大化的 SBP 进行估计，并生成 95% CI。 结果：在中位随访 19.8 年期间，16  570 名女性中有 9723 名 (59%) 存活至 90 岁。 65、70、75 和 80 岁时收缩压在 110 至 130 mm Hg 之间的女性的患病率分别为 38% (95% CI, 34%–48%)、54% (52%–56%)、66生存到 90 岁的绝对概率分别为 % (64%–67%) 或 75% (73%–78%)。 SBP 水平越高，存活到 90 岁的概率就越低。 80 岁女性中，0%、20%、40%、60%、80% 或 100% 时间处于治疗范围（定义为收缩压在 110 至 130 mm Hg 之间）的女性的 66% (64% –69%)、68% (67%–70%)、71% (69%–72%)、73% (71%–74%)、75% (72%–77%) 或 77% (74 %–79%) 到 90 岁的绝对生存概率。结论：对于 65 岁以上、心血管疾病和其他慢性疾病风险较低的女性，SBP 水平 <130 mm Hg 被发现与长寿相关。这些发现强化了当前针对老年女性收缩压目标<130毫米汞柱的指南。