Determinants of the components of arterial pressure among older adults--the role of anthropometric and clinical factors: a multi-continent study

Atherosclerosis. 2015 Feb;238(2):240-9. doi: 10.1016/j.atherosclerosis.2014.11.029. Epub 2014 Dec 9.


Objective: The aim of this study was to evaluate the factors associated with different components of arterial blood pressure in nine nationally-representative samples of people aged ≥50 years.

Methods: Data were available for 53,289 people aged ≥18 years who participated in the SAGE (WHO Study on global AGEing and adult health) study conducted in China, Ghana, India, Mexico, Russia, and South Africa, and the COURAGE (Collaborative Research on Ageing in Europe) study conducted in Finland, Poland, and Spain, between 2007 and 2012. Standard procedures were used to obtain diastolic and systolic blood pressure (DBP, SBP) measurements to identify hypertensive participants, and to determine mean arterial blood pressure (MAP) and pulse pressure (PP).

Results: The analytical sample consisted of 42,116 people aged 50 years or older. South Africa had the highest prevalence of hypertension (78.3%), and the highest measurements of MAP ± SD (113.6 ± 36.4 mmHg), SBP ± SD (146.4 ± 49.5 mmHg), and DBP ± SD (97.2 ± 33.9 mmHg). In the adjusted models, dose-dependent positive associations between Body Mass Index (BMI) and MAP or PP were observed in most countries (p < 0.05). Diabetes was positively associated with PP in most countries but the association between diabetes and MAP was less consistent. Stroke was associated with both higher MAP and PP in China, Ghana, and South Africa (p < 0.05).

Conclusions: Obesity and diabetes remain important modifiable risk factors for arterial peripheral resistance and stiffness as reflected by MAP and PP respectively. Controlling arterial pressure abnormalities after stroke events may be important for secondary prevention, particularly in developing countries.

Keywords: Developing countries; Hypertension; Mean arterial pressure; Obesity; Pulse pressure.

Publication types

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

MeSH terms

  • Adult
  • Africa / epidemiology
  • Age Factors
  • Aged
  • Anthropometry*
  • Arterial Pressure*
  • Asia / epidemiology
  • Body Mass Index
  • Comorbidity
  • Cross-Sectional Studies
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / epidemiology
  • Europe / epidemiology
  • Female
  • Humans
  • Hypertension / diagnosis
  • Hypertension / epidemiology*
  • Hypertension / physiopathology
  • Male
  • Mexico / epidemiology
  • Middle Aged
  • Obesity / diagnosis
  • Obesity / epidemiology
  • Prevalence
  • Risk Factors
  • Stroke / diagnosis
  • Stroke / epidemiology
  • Time Factors
  • Vascular Resistance
  • Vascular Stiffness