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Intensive BP control in older adults yields no effect on mobility
In adults aged at least 75 years, treating to a systolic BP target of 120 mm Hg did not affect changes in gait speed and was not associated with changes in mobility limitation, according to data from SPRINT.
Michelle C. Odden, PhD, assistant professor in the School of Biological and Population Health Sciences at Oregon State University, and colleagues analyzed adults aged 75 years or older (n = 2,629; 62% men; mean age, 80 years) with hypertension and no history of type 2 diabetes or stroke, who were randomly assigned to intensive treatment with a target systolic BP < 120 mm Hg or standard treatment with a target systolic BP < 140 mm Hg. Data were collected between November 2010 and December 2015. Gait speed was measured using a 4-m walk test and mobility was self-reported through the Veterans RAND 12-item Health Survey and the EuroQol-5D.
No differences were found in mean gait speed decline between the intensive- and standard-treatment groups (mean difference, 0.0004 m/s per year; 95% CI, –0.005 to 0.005). Gait speed decline did not differ significantly for subgroups defined by age, sex, race or ethnicity, baseline BP, chronic kidney disease or history of CVD.
A modest, but not statistically significant, interaction was found between Veterans RAND 12-item Health Survey summary scores and the two subgroups (participants with score 40: mean difference, 0.004 m/s per year; 95% CI, –0.002 to 0.01; participants with score < 40: mean difference, –0.008 m/s per year; 95% CI, –0.016 to 0.001).
“Several possible reasons explain why intensive treatment did not substantially affect gait speed or mobility outcomes in SPRINT participants 75 years or older or in most of the subgroups examined,” the researchers wrote. “Gait speed incorporates function across multiple domains, including cardiorespiratory fitness, musculoskeletal health, vision, balance and even mood or psychosocial health; therefore, the [CV] benefit conferred from intensive BP control might not extend to mobility outcomes owing to the multifactorial nature of mobility.” – by Cassie Homer
Disclosure: Odden report no relevant financial disclosures. One researcher reports serving as a consultant to Cricket Health and Vital Labs.