Blood pressure related to age: The India ABPM study

J Clin Hypertens (Greenwich). 2019 Dec;21(12):1784-1794. doi: 10.1111/jch.13744. Epub 2019 Nov 25.

Abstract

The present paper reports trends in office blood pressure (BP) measurement (OBPM) and ambulatory blood pressure measurement (ABPM) with age in a large multi-center Indian all comers' population visiting primary care physicians. ABPM and OBPM data from 27 472 subjects (aged 51 ± 14 years, males 68.2%, treated 45.5%) were analyzed and compared. Individual differences between OBPM and ABPM patterns were compared for patients according to 10-year age categories. Results showed that systolic (S) BP values started to increase with age from the age of 40, BP variability (SD) increased from the age of 30 years. Diastolic (D) BP values started to decrease from the age of 50 years. Mean OBPM values were higher than daytime ABPM values (all P < .001) in all age-groups. The prevalence of white coat hypertension (WCH) and masked hypertension (MH) was based on OBPM and daytime, 24-hour, and nighttime average BPs together. WCH decreased with age from 15.1% and 12.4% in treated and untreated subjects at the youngest age to 7.2% and 6.9% in the oldest age, respectively. MH prevalence was higher for untreated than for treated subjects but remained similar for all age-groups (range of 18.6%-21.3%). The prevalence of reverse dippers increased with age from the youngest to oldest group with 7.3%-34.2% (P < .001 for trend). Dippers prevalence decreased from 42.5% to 17.9% from the youngest to oldest age-groups, respectively (P < .001 for trend). These findings confirm that BP patterns show clear differences in trends with age, particularly regarding nighttime BP.

Keywords: India; ambulatory blood pressure measurement; hypertension management; isolated nighttime hypertension; masked hypertension; office blood pressure measurement; white coat hypertension.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use
  • Biological Variation, Population / physiology
  • Blood Pressure / physiology*
  • Blood Pressure Determination / instrumentation*
  • Blood Pressure Monitoring, Ambulatory / methods*
  • Case-Control Studies
  • Circadian Rhythm
  • Diastole / physiology
  • Female
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy
  • Hypertension / physiopathology*
  • India / epidemiology
  • Male
  • Masked Hypertension / diagnosis
  • Masked Hypertension / drug therapy
  • Masked Hypertension / epidemiology
  • Middle Aged
  • Prevalence
  • Primary Health Care / statistics & numerical data
  • Systole / physiology
  • White Coat Hypertension / diagnosis
  • White Coat Hypertension / drug therapy
  • White Coat Hypertension / epidemiology

Substances

  • Antihypertensive Agents