{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T16:57:01Z","timestamp":1783702621092,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,12,30]],"date-time":"2016-12-30T00:00:00Z","timestamp":1483056000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To estimate outcomes according to attained blood pressure (\n                      <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\n                      ) in the oldest adults treated for hypertension in routine family practice.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cohort analysis of primary care inpatient and death certificate data for individuals with hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Primary care practices in England (Clinical Practice Research Datalink).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Individuals aged 80 and older taking antihypertensive medication and free of dementia, cancer, coronary heart disease, stroke, heart failure, and end\u2010stage renal failure at baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>\n                      Outcomes were mortality, cardiovascular events, and fragility fractures. Systolic\n                      <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\n                      (\n                      <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>\n                      ) was grouped in 10\u2010mmHg increments from less than 125 to 185 mmHg or more (reference 145\u2013154 mmHg).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Myocardial infarction hazards increased linearly with increasing\n                      <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>\n                      , and stroke hazards increased for\n                      <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>\n                      of 145 mmHg or greater, although lowest mortality was in individuals with\n                      <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>\n                      of 135 to 154 mmHg. Mortality of the 13.1% of patients with\n                      <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>\n                      less than 135 mmHg was higher than that of the reference group (Cox hazard ratio=1.25, 95% confidence interval=1.19\u20131.31; equating to one extra death per 12.6 participants). This difference in mortality was consistent over short\u2010 and long\u2010term follow\u2010up; adjusting for diastolic\n                      <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\n                      did not change the risk. Incident heart failure rates were higher in those with\n                      <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>\n                      less than 125 mmHg than in the reference group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In routine primary care,\n                      <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>\n                      less than 135 mmHg was associated with greater mortality in the oldest adults with hypertension and free of selected potentially confounding comorbidities. Although important confounders were accounted for, observational studies cannot exclude residual confounding. More work is needed to establish whether unplanned\n                      <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>\n                      s less than 135 mmHg in older adults with hypertension may be a useful clinical sign of poor prognosis, perhaps requiring clinical review of overall care.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.14712","type":"journal-article","created":{"date-parts":[[2016,12,30]],"date-time":"2016-12-30T20:58:56Z","timestamp":1483131536000},"page":"995-1003","source":"Crossref","is-referenced-by-count":34,"title":["Outcomes of Treated Hypertension at Age 80 and Older: Cohort Analysis of 79,376 Individuals"],"prefix":"10.1111","volume":"65","author":[{"given":"Jo\u00e3o","family":"Delgado","sequence":"first","affiliation":[{"name":"Epidemiology and Public Health Institute of Biomedical and Clinical Science University of Exeter Medical School Exeter United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane A. 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David","family":"Strain","sequence":"additional","affiliation":[{"name":"Healthcare for Older People Royal Devon and Exeter National Health Service Foundation Trust Exeter United Kingdom"},{"name":"Department of Diabetes and Vascular Medicine University of Exeter Medical School Exeter United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George A.","family":"Kuchel","sequence":"additional","affiliation":[{"name":"Center on Aging University of Connecticut Health Center Farmington Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Walters","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Health University College London Gower Street Campus London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Lafortune","sequence":"additional","affiliation":[{"name":"Cambridge Institute of Public Health School of Clinical Medicine University of Cambridge Cambridge United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Brayne","sequence":"additional","affiliation":[{"name":"Cambridge Institute of Public Health School of Clinical Medicine University of Cambridge Cambridge United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Melzer","sequence":"additional","affiliation":[{"name":"Epidemiology and Public Health Institute of Biomedical and Clinical Science University of Exeter Medical School Exeter United Kingdom"},{"name":"Center on Aging University of Connecticut Health Center Farmington Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4917-3810","authenticated-orcid":false,"given":"Alessandro","family":"Ble","sequence":"additional","affiliation":[{"name":"Epidemiology and Public Health Institute of Biomedical and Clinical Science University of Exeter Medical School Exeter United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"As part of the Ageing Well Programme of the NIHR School for Public Health Research, England","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,12,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afu113"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht151"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.284427"},{"key":"e_1_2_7_5_1","volume-title":"Hypertension: Guidance and Guidelines","author":"National Institute for Health and Care Excellence","year":"2013"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000000065"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jash.2011.06.001"},{"key":"e_1_2_7_8_1","first-page":"2669","article-title":"SPRINT results in older patients: How low to go?","volume":"315","author":"Chobanian AV","year":"2016","journal-title":"J Am Geriatr Soc"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv098"},{"key":"e_1_2_7_10_1","first-page":"1","volume-title":"QOF Implementation Dataset and Business Rules \u2010 Hypertension (HYP) Indicator Set [Internet]","author":"HSCIC"},{"key":"e_1_2_7_11_1","unstructured":"(WHO) WHO.ICD\u201010 Version:2015 [Internet].2015[cited 2016 Dec 5]. 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