Abstract
The results of major randomized clinical trials suggest the potential benefits of a more pronounced reduction in systolic blood pressure (SBP) at initially low levels of diastolic blood pressure (DBP). However, concerns persist regarding the safety of excessive DBP reduction in isolated systolic hypertension (ISH). In this regard, it is of interest to analyze data from participants of the large cross-sectional observational EUCALYPT study, which included elderly individuals, to assess the relationship between DBP levels and the likelihood of a history of cardiovascular disease (CVD) complications and geriatric syndromes.
Aim. The study aimed to evaluate the relationship between DBP levels and the prevalence of CVD and its complications, as well as the severity of geriatric syndromes in elderly individuals.
Materials and methods. The epidemiological EUCALYPT study included 4,308 individuals aged 65 to 107 years (mean age 78±8 years; 30% men) from 11 regions of the Russian Federation between April 2018 and October 2019. The prevalence of hypertension among participants was 88.6%, with SBP levels below 130 mmHg observed in 69.4% of cases. All participants underwent a comprehensive geriatric assessment, which included both a specially developed questionnaire and physical examination. For this analysis, participants were divided into six age groups.
Results. The number of participants with DBP levels corresponding to the 1st, 2nd, 3rd, and 4th quartiles was 1,302, 1,143, 687, and 1,018 individuals, respectively. In the subgroup of participants with DBP levels in the 1st quartile (i.e., lower DBP), there were more men, lower SBP levels, and a higher prevalence of diagnosed CVD, type 2 diabetes mellitus (T2DM), and chronic kidney disease compared to participants with DBP levels in the 2nd, 3rd, or 4th quartiles.
Conclusions. The results indicate a statistically significant association between low DBP levels and the prevalence of CVD complications, as well as conditions such as chronic kidney failure, anemia, and T2DM. In the subgroup with the lowest DBP levels, geriatric issues such as frailty, dependence on external assistance, cognitive impairment, malnutrition, urinary incontinence, pain, and falls were more frequently observed. However, the relationship between these CVD complications or their severity was more strongly associated with age than with specific DBP levels.
Keywords: diastolic blood pressure, cardiovascular disease complications, geriatric syndromes, frailty.
Aim. The study aimed to evaluate the relationship between DBP levels and the prevalence of CVD and its complications, as well as the severity of geriatric syndromes in elderly individuals.
Materials and methods. The epidemiological EUCALYPT study included 4,308 individuals aged 65 to 107 years (mean age 78±8 years; 30% men) from 11 regions of the Russian Federation between April 2018 and October 2019. The prevalence of hypertension among participants was 88.6%, with SBP levels below 130 mmHg observed in 69.4% of cases. All participants underwent a comprehensive geriatric assessment, which included both a specially developed questionnaire and physical examination. For this analysis, participants were divided into six age groups.
Results. The number of participants with DBP levels corresponding to the 1st, 2nd, 3rd, and 4th quartiles was 1,302, 1,143, 687, and 1,018 individuals, respectively. In the subgroup of participants with DBP levels in the 1st quartile (i.e., lower DBP), there were more men, lower SBP levels, and a higher prevalence of diagnosed CVD, type 2 diabetes mellitus (T2DM), and chronic kidney disease compared to participants with DBP levels in the 2nd, 3rd, or 4th quartiles.
Conclusions. The results indicate a statistically significant association between low DBP levels and the prevalence of CVD complications, as well as conditions such as chronic kidney failure, anemia, and T2DM. In the subgroup with the lowest DBP levels, geriatric issues such as frailty, dependence on external assistance, cognitive impairment, malnutrition, urinary incontinence, pain, and falls were more frequently observed. However, the relationship between these CVD complications or their severity was more strongly associated with age than with specific DBP levels.
Keywords: diastolic blood pressure, cardiovascular disease complications, geriatric syndromes, frailty.
For citation:Shchedrina A.Yu., Gilyarevskiy S.R., Eruslanova K.A., Kotovskaya Yu.V., Tkacheva O.N. The characteristics of diastolic blood pressure depending on age and its associations with cardiovascular diseases and geriatric syndromes in patients over 65 years old: data from observation EVKALIPT study. Clinical review for general practice. 2025; 6 (10): 73–80 (In Russ.). DOI: 10.47407/kr2025.6.10.00696
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