Re: Centenarian Body Mass Index and blood pressure

[Guest guest]

I f memory serves, the shorter you are, the more likely the BMI numbers are likely to be skewed (as in screwed) so that they give a distortedly low number (the opposite for very tall people). Similarly with the BMIs of children, yes?

Maco

[ ] Centenarian Body Mass Index and blood pressure

It was interesting to note that the BMI for centenarians was 21±3.3for men and 18±1.9 for women. A BMI of 21 is what our filesindicate offers the best protection from CVD, diabetes, and otherdiseases. The centenarian men's BMI ranged from 17.7 to 24.3 whichextends slightly below the "normal" BMI range (18.5 to 24.9). It wassurprising that centenarian women had BMIs around 18 and that asubstantial part of the range of 16.1 to 19.9 is below normal.Some of our recent posts about blood pressure have indicated concernabout moderate hypertension which is considered to be a systolic BPexceeding 120 mm Hg. However, centenarians had BPs with averagesystolic daytime values of 129±22.It seems that moderately high blood pressure is not an impediment tolongevity. BMI seems to be more important.Tony--- In , Al Pater <old542000@y...>wrote:> Hi All,> A new paper on centenarian blood pressure has been published. Itexamines a> particularly longevous population for the level of blood pressureamong its> centenarians, compared with much less elderly members of the samepopulation. It is> described in partial detail below from its similarly availablefull-text.> > Am J Hypertens. 2005 Aug;18(8):1040-5.> White coat hypertension in centenarians.> Jumabay M, Ozawa Y, Kawamura H, Saito S, Izumi Y, Mitsubayashi H,Kasamaki Y,> Nakayama T, Cheng Z, Ma Y, Mahumut M.> BACKGROUND: To study white coat (WC) hypertension incentenarians, a> cross-sectional surveillance was carried out on Uygurs, a long-livedpopulation in> China. METHODS: Twenty-four-hour ambulatory blood pressure (BP)monitoring (ABPM)> was performed in 33 centenarians (age range, 100 to 113 years) andcompared with 100> elderly subjects (age range, 65 to 70 years). All subjects wereclinically healthy> and capable of self-care. Subjects had no history, signs, orsymptoms of> cardiovascular disease and were receiving no medical treatments.Office BP, 24-h> mean, daytime and night-time BP, pulse pressure, heart rate,standard deviation> (SD), and coefficient of variation (CV) of the same variables wereextracted from> ABPM. The WC effect was defined as the difference between meanoffice and daytime> BP. RESULTS: Centenarians demonstrated higher prevalence of WChypertension,> compared to elderly group (15% vs. 5%). The WC effect was alsogreater in> centenarians than in elderly subjects, and was more marked forsystolic BP than for> diastolic BP and heart rate. The WC effect for systolic BP waspositively correlated> with both SD (r = 0.45, P < .01) and CV (r = 0.55, P < .01) for 24-hsystolic BP in> centenarians, but not in elderly subjects. CONCLUSIONS: Prevalenceof WC> hypertension was greater in centenarians than in elderly subjects.The WC effect and> BP variation may be increased in centenarians. Previously observedhigher BPs seen> in very elderly individuals might be explained by the greater impactof WC> hypertension. PMID: 16109317> > ... Results> > Physiologic Characteristics of Subjects> > ... Table 1. Physiologic characteristics of subjects> .....................................> Elderly (n = 100) Centenarian (n = 33) > .....................................> ------Men/women 66/34 25/8 > Age (y) > Men 68±2.0 104±5 > Women 67±2.0 104±3 > Height (cm) > Men 160±5.7 154±12 †> Women 149±4.7 148±6.9 > Weight (kg) > Men 55±5.8 53±6.6 †> Women 46±6.7 40±5.6 †> BMI (kg/m2) > Men 21±1.9 21±3.3 > Women 21±2.8 18±1.9 > ...................................> BMI = body mass index.> Values are means±SD.> †P < .01, differences between the elderly and centenariangroups.> > ... Table 2. White coat effect> ...................................> ----Elderly (n = 100) Centenarian (n = 33) > ...................................> Office> SBP (mm Hg) 128±10.3 145±10.1 †> DBP (mm Hg) 74±5.8 85±6.9 †> HR (beats/min) 83±3.3 82±5.1 > Daytime > SBP (mm Hg) 123±17 129±22 †> DBP (mm Hg) 72±7.2 74±11 > HR (beats/min) 80±8.5 79±11 > White coat effect > SBP (mm Hg) 15±11.9 19±8.8 †> DBP (mm Hg) 10±8.1 12±5.1 > HR (beats/min) 10±5.7 11±6.0 > .....................................> SBP = systolic blood pressure; DBP = diastolic blood pressure; HR =heart rate.> Values are means±SD.> †P < .01, differences between the elderly and centenariangroups.> > ... Table 3. Blood pressure and pulse rate on ambulatory monitoring> ...................................> ----Elderly (n = 100) Centenarian (n = 33) > ...................................> Mean 24-h > SBP (mm Hg) 121±16 128±23 †> DBP (mm Hg) 72±6.8 71±12 > PP (mm Hg) 45±21 60±15 †> HR (beats/min) 78±8.9 76±11 > Daytime > SBP (mm Hg) 123±17 129±22 †> DBP (mm Hg) 72±7.2 74±11 > HR (beats/min) 80±8.5 79±11 > Night-time > SBP (mm Hg) 117±18 127±20 †> DBP (mm Hg) 68±7 70±14 > HR (beats/min) 71±12 71±13 > Daytime–night-time > SBP (mm Hg) 9.5±7.4 1.7±1.2 †> DBP (mm Hg) 2.8±1.5 2.6±1.1 > HR (beats/min) 10.6±5.5 9.5±7.1 > ......................................> Abbreviations as in Table 2; PP = pulse pressure.> Values are means±SD.> †P < .01, differences between the elderly and centenariangroups.> > Circadian BP and HR profiles are shown in Fig. 1. Two peaks and onedip pattern> characterized circadian systolic BP in elderly subjects. Circadianvariations in> systolic BP showed multiple peaks, and the overall pattern tended tobe flatter in> centenarians. However, circadian patterns for HR were similarbetween centenarians> and elderly subjects. > > The SD and CV for 30-min variations in 24-h measurements are shownin Fig. 2. The SD> and CV for BP were higher in centenarians than in elderly subjects.However, no> significant differences in SD or CV of HR were observed betweenelderly subjects and> centenarians. > > FIG. 2. Blood pressure variations every 30 min for 24 h in elderlyand centennial> groups. SD = standard deviation; CV = coefficient of variation;other abbreviations> as in Fig. 1.> > The WC effect was associated with SD and CV for 24-h BP incentenarians. The WC> effect for systolic BP was positively correlated with both SD (r =0.45, P < .01)> and CV (r = 0.55, P < .01) of 24-h systolic BP in centenarians, butnot in elderly> subjects (Fig. 3). However, the WC effect for diastolic BP wasunrelated to SD or CV> of 24-h diastolic BP in both elderly subjects (SD: r = 0.09, P =.352; CV: r = 0.06,> P = .253) and centenarians (SD: r = 0.13, P = .113; CV: r = 0.15, P= .082). > > Discussion> > ...Centenarians and WC Hypertension> > In the Hotan region, an area densely populated by Uygurs, theproportion of> centenarians in the population is 18.9/100,000.4 The Uygurs inXinjiang, China, are> particularly long-lived. Extreme longevity in humans seems to beassociated with> numerous factors. In the present study, incidence of hypertensionwas lower in> elderly Uygur subjects (65- to 70-year-old) than in the generalChinese elderly> population. Prevalence of hypertension differs according toethnicity in China, but> averages 13.58% in the general population and 32% to 49% in elderlysubjects.13 and> 14 Uygur elderly subjects, presenting as less hypertensive, mayrepresent the best> candidates for becoming centenarians.> > Although aged individuals are typically thought to display reducedresponse to> stressors, WC hypertension in the present study was greater incentenarians than in> elderly subjects. Supporting this finding, another study has shownthat office BP> was higher than mean 24-h BP values in centenarians (N = 11).5However, the WC> effect and WC hypertension were not shown in centenarians in thatstudy. A small> number of studies in older subjects have suggested that clinic BP isgreater than> ambulatory BP, and this difference between clinic and ambulatory BPincreases with> age,7 and 8 although subjects in those studies were <80 years old. Acontrasting> report shows that BP variation increases with age, particularlyafter 60 years> old.15 However, no centenarians were investigated in that study. Inour study, WC> hypertension was more prevalent in centenarians than in elderlysubjects, indicating> that prevalence of hypertension in centenarians might differ fromthat in other> elderly populations.> > The phenomenon of WC hypertension may reflect an abnormally vigoroussympathetic> nerve response to the measurement environment, particularly in thepresence of the> measuring nurse or physician. However, in the present study, ABPMwas conducted in> all subjects at the same period and in the same environment, andfrequency and time> of office visits were similar between elderly and centenariansubjects. However,> research has shown that BP reactions to measurements by clinicalstaff are> associated with enhanced BP responses to mental stress testing.16 Incontrast,> Parati et al17 found that mental laboratory stressors did notcorrelate with> increases in BP accompanying a visit by a physician. Conflictingresults exist on> whether patients with WC hypertension are more susceptible to mentalstress than> normal subjects.> > In the present study, despite increases in both clinical andambulatory BP in> centenarians, the WC effect was obviously greater for systolic thanfor diastolic BP> or HR, indicating that arterial arteriosclerosis might be progressedand responsive> to minimal stressors. Centenarians in the present study demonstrateda sharp> increase in PP and increased prevalence of isolated systolichypertension, revealing> that arterial vessels might be "reactive" for given stimuli.Therefore, high> responsiveness may be due to a higher level of adaptive morphologicchanges in> thickened vascular walls.> > BP Variation> > In the present study, the same day–night definition was usedfor allsubjects.> However, night-time systolic BP was higher in centenarians than inelderly subjects.> One study has shown that reduced nocturnal BP declines in the veryelderly,> particularly in women.18 Another study indicated the flattedcircadian pattern of BP> involves activity, sleeping quality, and arteriosclerosis.19 In thepresent study,> centenarians also displayed high night-time systolic BP, andpresented a> nondipper-type of circadian pattern. Decreased compliance of thelarge elastic> arteries in centenarians may lead to disturbance of baroreceptorreflex function, in> turn resulting in increased variability of BP, for systolic BP inparticular.> > Centenarians in this study demonstrated higher SDs and CVs comparedto elderly> subjects, and the WC effect correlated with BP variations. The BPvariation may> represent one of the factors affecting the WC effect incentenarians, and might> involve reduced function of cardiac and vascular modulation systemsthat control> cardiovascular variation. An earlier study has shown that BPvariability may also> represent an increased risk factor, given an association withimpaired arterial> distensibility.20 Centenarians might thus be at higher risk ofcardiovascular> disease and mortality because of their advanced age. ...> > ...> > Al Pater, PhD; email: old542000@y...

[Guest guest]

I f memory serves, the shorter you are, the more likely the BMI numbers are likely to be skewed (as in screwed) so that they give a distortedly low number (the opposite for very tall people). Similarly with the BMIs of children, yes?

Maco

[ ] Centenarian Body Mass Index and blood pressure

It was interesting to note that the BMI for centenarians was 21±3.3for men and 18±1.9 for women. A BMI of 21 is what our filesindicate offers the best protection from CVD, diabetes, and otherdiseases. The centenarian men's BMI ranged from 17.7 to 24.3 whichextends slightly below the "normal" BMI range (18.5 to 24.9). It wassurprising that centenarian women had BMIs around 18 and that asubstantial part of the range of 16.1 to 19.9 is below normal.Some of our recent posts about blood pressure have indicated concernabout moderate hypertension which is considered to be a systolic BPexceeding 120 mm Hg. However, centenarians had BPs with averagesystolic daytime values of 129±22.It seems that moderately high blood pressure is not an impediment tolongevity. BMI seems to be more important.Tony--- In , Al Pater <old542000@y...>wrote:> Hi All,> A new paper on centenarian blood pressure has been published. Itexamines a> particularly longevous population for the level of blood pressureamong its> centenarians, compared with much less elderly members of the samepopulation. It is> described in partial detail below from its similarly availablefull-text.> > Am J Hypertens. 2005 Aug;18(8):1040-5.> White coat hypertension in centenarians.> Jumabay M, Ozawa Y, Kawamura H, Saito S, Izumi Y, Mitsubayashi H,Kasamaki Y,> Nakayama T, Cheng Z, Ma Y, Mahumut M.> BACKGROUND: To study white coat (WC) hypertension incentenarians, a> cross-sectional surveillance was carried out on Uygurs, a long-livedpopulation in> China. METHODS: Twenty-four-hour ambulatory blood pressure (BP)monitoring (ABPM)> was performed in 33 centenarians (age range, 100 to 113 years) andcompared with 100> elderly subjects (age range, 65 to 70 years). All subjects wereclinically healthy> and capable of self-care. Subjects had no history, signs, orsymptoms of> cardiovascular disease and were receiving no medical treatments.Office BP, 24-h> mean, daytime and night-time BP, pulse pressure, heart rate,standard deviation> (SD), and coefficient of variation (CV) of the same variables wereextracted from> ABPM. The WC effect was defined as the difference between meanoffice and daytime> BP. RESULTS: Centenarians demonstrated higher prevalence of WChypertension,> compared to elderly group (15% vs. 5%). The WC effect was alsogreater in> centenarians than in elderly subjects, and was more marked forsystolic BP than for> diastolic BP and heart rate. The WC effect for systolic BP waspositively correlated> with both SD (r = 0.45, P < .01) and CV (r = 0.55, P < .01) for 24-hsystolic BP in> centenarians, but not in elderly subjects. CONCLUSIONS: Prevalenceof WC> hypertension was greater in centenarians than in elderly subjects.The WC effect and> BP variation may be increased in centenarians. Previously observedhigher BPs seen> in very elderly individuals might be explained by the greater impactof WC> hypertension. PMID: 16109317> > ... Results> > Physiologic Characteristics of Subjects> > ... Table 1. Physiologic characteristics of subjects> .....................................> Elderly (n = 100) Centenarian (n = 33) > .....................................> ------Men/women 66/34 25/8 > Age (y) > Men 68±2.0 104±5 > Women 67±2.0 104±3 > Height (cm) > Men 160±5.7 154±12 †> Women 149±4.7 148±6.9 > Weight (kg) > Men 55±5.8 53±6.6 †> Women 46±6.7 40±5.6 †> BMI (kg/m2) > Men 21±1.9 21±3.3 > Women 21±2.8 18±1.9 > ...................................> BMI = body mass index.> Values are means±SD.> †P < .01, differences between the elderly and centenariangroups.> > ... Table 2. White coat effect> ...................................> ----Elderly (n = 100) Centenarian (n = 33) > ...................................> Office> SBP (mm Hg) 128±10.3 145±10.1 †> DBP (mm Hg) 74±5.8 85±6.9 †> HR (beats/min) 83±3.3 82±5.1 > Daytime > SBP (mm Hg) 123±17 129±22 †> DBP (mm Hg) 72±7.2 74±11 > HR (beats/min) 80±8.5 79±11 > White coat effect > SBP (mm Hg) 15±11.9 19±8.8 †> DBP (mm Hg) 10±8.1 12±5.1 > HR (beats/min) 10±5.7 11±6.0 > .....................................> SBP = systolic blood pressure; DBP = diastolic blood pressure; HR =heart rate.> Values are means±SD.> †P < .01, differences between the elderly and centenariangroups.> > ... Table 3. Blood pressure and pulse rate on ambulatory monitoring> ...................................> ----Elderly (n = 100) Centenarian (n = 33) > ...................................> Mean 24-h > SBP (mm Hg) 121±16 128±23 †> DBP (mm Hg) 72±6.8 71±12 > PP (mm Hg) 45±21 60±15 †> HR (beats/min) 78±8.9 76±11 > Daytime > SBP (mm Hg) 123±17 129±22 †> DBP (mm Hg) 72±7.2 74±11 > HR (beats/min) 80±8.5 79±11 > Night-time > SBP (mm Hg) 117±18 127±20 †> DBP (mm Hg) 68±7 70±14 > HR (beats/min) 71±12 71±13 > Daytime–night-time > SBP (mm Hg) 9.5±7.4 1.7±1.2 †> DBP (mm Hg) 2.8±1.5 2.6±1.1 > HR (beats/min) 10.6±5.5 9.5±7.1 > ......................................> Abbreviations as in Table 2; PP = pulse pressure.> Values are means±SD.> †P < .01, differences between the elderly and centenariangroups.> > Circadian BP and HR profiles are shown in Fig. 1. Two peaks and onedip pattern> characterized circadian systolic BP in elderly subjects. Circadianvariations in> systolic BP showed multiple peaks, and the overall pattern tended tobe flatter in> centenarians. However, circadian patterns for HR were similarbetween centenarians> and elderly subjects. > > The SD and CV for 30-min variations in 24-h measurements are shownin Fig. 2. The SD> and CV for BP were higher in centenarians than in elderly subjects.However, no> significant differences in SD or CV of HR were observed betweenelderly subjects and> centenarians. > > FIG. 2. Blood pressure variations every 30 min for 24 h in elderlyand centennial> groups. SD = standard deviation; CV = coefficient of variation;other abbreviations> as in Fig. 1.> > The WC effect was associated with SD and CV for 24-h BP incentenarians. The WC> effect for systolic BP was positively correlated with both SD (r =0.45, P < .01)> and CV (r = 0.55, P < .01) of 24-h systolic BP in centenarians, butnot in elderly> subjects (Fig. 3). However, the WC effect for diastolic BP wasunrelated to SD or CV> of 24-h diastolic BP in both elderly subjects (SD: r = 0.09, P =.352; CV: r = 0.06,> P = .253) and centenarians (SD: r = 0.13, P = .113; CV: r = 0.15, P= .082). > > Discussion> > ...Centenarians and WC Hypertension> > In the Hotan region, an area densely populated by Uygurs, theproportion of> centenarians in the population is 18.9/100,000.4 The Uygurs inXinjiang, China, are> particularly long-lived. Extreme longevity in humans seems to beassociated with> numerous factors. In the present study, incidence of hypertensionwas lower in> elderly Uygur subjects (65- to 70-year-old) than in the generalChinese elderly> population. Prevalence of hypertension differs according toethnicity in China, but> averages 13.58% in the general population and 32% to 49% in elderlysubjects.13 and> 14 Uygur elderly subjects, presenting as less hypertensive, mayrepresent the best> candidates for becoming centenarians.> > Although aged individuals are typically thought to display reducedresponse to> stressors, WC hypertension in the present study was greater incentenarians than in> elderly subjects. Supporting this finding, another study has shownthat office BP> was higher than mean 24-h BP values in centenarians (N = 11).5However, the WC> effect and WC hypertension were not shown in centenarians in thatstudy. A small> number of studies in older subjects have suggested that clinic BP isgreater than> ambulatory BP, and this difference between clinic and ambulatory BPincreases with> age,7 and 8 although subjects in those studies were <80 years old. Acontrasting> report shows that BP variation increases with age, particularlyafter 60 years> old.15 However, no centenarians were investigated in that study. Inour study, WC> hypertension was more prevalent in centenarians than in elderlysubjects, indicating> that prevalence of hypertension in centenarians might differ fromthat in other> elderly populations.> > The phenomenon of WC hypertension may reflect an abnormally vigoroussympathetic> nerve response to the measurement environment, particularly in thepresence of the> measuring nurse or physician. However, in the present study, ABPMwas conducted in> all subjects at the same period and in the same environment, andfrequency and time> of office visits were similar between elderly and centenariansubjects. However,> research has shown that BP reactions to measurements by clinicalstaff are> associated with enhanced BP responses to mental stress testing.16 Incontrast,> Parati et al17 found that mental laboratory stressors did notcorrelate with> increases in BP accompanying a visit by a physician. Conflictingresults exist on> whether patients with WC hypertension are more susceptible to mentalstress than> normal subjects.> > In the present study, despite increases in both clinical andambulatory BP in> centenarians, the WC effect was obviously greater for systolic thanfor diastolic BP> or HR, indicating that arterial arteriosclerosis might be progressedand responsive> to minimal stressors. Centenarians in the present study demonstrateda sharp> increase in PP and increased prevalence of isolated systolichypertension, revealing> that arterial vessels might be "reactive" for given stimuli.Therefore, high> responsiveness may be due to a higher level of adaptive morphologicchanges in> thickened vascular walls.> > BP Variation> > In the present study, the same day–night definition was usedfor allsubjects.> However, night-time systolic BP was higher in centenarians than inelderly subjects.> One study has shown that reduced nocturnal BP declines in the veryelderly,> particularly in women.18 Another study indicated the flattedcircadian pattern of BP> involves activity, sleeping quality, and arteriosclerosis.19 In thepresent study,> centenarians also displayed high night-time systolic BP, andpresented a> nondipper-type of circadian pattern. Decreased compliance of thelarge elastic> arteries in centenarians may lead to disturbance of baroreceptorreflex function, in> turn resulting in increased variability of BP, for systolic BP inparticular.> > Centenarians in this study demonstrated higher SDs and CVs comparedto elderly> subjects, and the WC effect correlated with BP variations. The BPvariation may> represent one of the factors affecting the WC effect incentenarians, and might> involve reduced function of cardiac and vascular modulation systemsthat control> cardiovascular variation. An earlier study has shown that BPvariability may also> represent an increased risk factor, given an association withimpaired arterial> distensibility.20 Centenarians might thus be at higher risk ofcardiovascular> disease and mortality because of their advanced age. ...> > ...> > Al Pater, PhD; email: old542000@y...

[Guest guest]

Hi folks:

It would be even more interesting to know what the BMIs and blood

pressures of these centenarians had been during the course of their

lives. Neither of these numbers is necessarily fixed. Many older

people lose weight as they age. Some also shrink vertically as well,

affecting BMI even if their weight doesn't change. What were these

people's BMIs and BPs when they were 40? Or 60? Or 80?

Nevertheless those data do provide one important piece of the puzzle.

Rodney.

> > Hi All,

> > A new paper on centenarian blood pressure has been published. It

> examines a

> > particularly longevous population for the level of blood pressure

> among its

> > centenarians, compared with much less elderly members of the same

> population. It is

> > described in partial detail below from its similarly available

> full-text.

> >

> > Am J Hypertens. 2005 Aug;18(8):1040-5.

> > White coat hypertension in centenarians.

> > Jumabay M, Ozawa Y, Kawamura H, Saito S, Izumi Y, Mitsubayashi H,

> Kasamaki Y,

> > Nakayama T, Cheng Z, Ma Y, Mahumut M.

> > BACKGROUND: To study white coat (WC) hypertension in

> centenarians, a

> > cross-sectional surveillance was carried out on Uygurs, a long-

lived

> population in

> > China. METHODS: Twenty-four-hour ambulatory blood pressure (BP)

> monitoring (ABPM)

> > was performed in 33 centenarians (age range, 100 to 113 years) and

> compared with 100

> > elderly subjects (age range, 65 to 70 years). All subjects were

> clinically healthy

> > and capable of self-care. Subjects had no history, signs, or

> symptoms of

> > cardiovascular disease and were receiving no medical treatments.

> Office BP, 24-h

> > mean, daytime and night-time BP, pulse pressure, heart rate,

> standard deviation

> > (SD), and coefficient of variation (CV) of the same variables were

> extracted from

> > ABPM. The WC effect was defined as the difference between mean

> office and daytime

> > BP. RESULTS: Centenarians demonstrated higher prevalence of WC

> hypertension,

> > compared to elderly group (15% vs. 5%). The WC effect was also

> greater in

> > centenarians than in elderly subjects, and was more marked for

> systolic BP than for

> > diastolic BP and heart rate. The WC effect for systolic BP was

> positively correlated

> > with both SD (r = 0.45, P < .01) and CV (r = 0.55, P < .01) for

24-h

> systolic BP in

> > centenarians, but not in elderly subjects. CONCLUSIONS: Prevalence

> of WC

> > hypertension was greater in centenarians than in elderly subjects.

> The WC effect and

> > BP variation may be increased in centenarians. Previously observed

> higher BPs seen

> > in very elderly individuals might be explained by the greater

impact

> of WC

> > hypertension. PMID: 16109317

> >

> > ... Results

> >

> > Physiologic Characteristics of Subjects

> >

> > ... Table 1. Physiologic characteristics of subjects

> > .....................................

> > Elderly (n = 100) Centenarian (n = 33)

> > .....................................

> > ------Men/women 66/34 25/8

> > Age (y)

> > Men 68±2.0 104±5

> > Women 67±2.0 104±3

> > Height (cm)

> > Men 160±5.7 154±12 †

> > Women 149±4.7 148±6.9

> > Weight (kg)

> > Men 55±5.8 53±6.6 †

> > Women 46±6.7 40±5.6 †

> > BMI (kg/m2)

> > Men 21±1.9 21±3.3

> > Women 21±2.8 18±1.9

> > ...................................

> > BMI = body mass index.

> > Values are means±SD.

> > †P < .01, differences between the elderly and centenarian

> groups.

> >

> > ... Table 2. White coat effect

> > ...................................

> > ----Elderly (n = 100) Centenarian (n = 33)

> > ...................................

> > Office

> > SBP (mm Hg) 128±10.3 145±10.1 †

> > DBP (mm Hg) 74±5.8 85±6.9 †

> > HR (beats/min) 83±3.3 82±5.1

> > Daytime

> > SBP (mm Hg) 123±17 129±22 †

> > DBP (mm Hg) 72±7.2 74±11

> > HR (beats/min) 80±8.5 79±11

> > White coat effect

> > SBP (mm Hg) 15±11.9 19±8.8 †

> > DBP (mm Hg) 10±8.1 12±5.1

> > HR (beats/min) 10±5.7 11±6.0

> > .....................................

> > SBP = systolic blood pressure; DBP = diastolic blood pressure; HR

=

> heart rate.

> > Values are means±SD.

> > †P < .01, differences between the elderly and centenarian

> groups.

> >

> > ... Table 3. Blood pressure and pulse rate on ambulatory

monitoring

> > ...................................

> > ----Elderly (n = 100) Centenarian (n = 33)

> > ...................................

> > Mean 24-h

> > SBP (mm Hg) 121±16 128±23 †

> > DBP (mm Hg) 72±6.8 71±12

> > PP (mm Hg) 45±21 60±15 †

> > HR (beats/min) 78±8.9 76±11

> > Daytime

> > SBP (mm Hg) 123±17 129±22 †

> > DBP (mm Hg) 72±7.2 74±11

> > HR (beats/min) 80±8.5 79±11

> > Night-time

> > SBP (mm Hg) 117±18 127±20 †

> > DBP (mm Hg) 68±7 70±14

> > HR (beats/min) 71±12 71±13

> > Daytime–night-time

> > SBP (mm Hg) 9.5±7.4 1.7±1.2 †

> > DBP (mm Hg) 2.8±1.5 2.6±1.1

> > HR (beats/min) 10.6±5.5 9.5±7.1

> > ......................................

> > Abbreviations as in Table 2; PP = pulse pressure.

> > Values are means±SD.

> > †P < .01, differences between the elderly and centenarian

> groups.

> >

> > Circadian BP and HR profiles are shown in Fig. 1. Two peaks and

one

> dip pattern

> > characterized circadian systolic BP in elderly subjects. Circadian

> variations in

> > systolic BP showed multiple peaks, and the overall pattern tended

to

> be flatter in

> > centenarians. However, circadian patterns for HR were similar

> between centenarians

> > and elderly subjects.

> >

> > The SD and CV for 30-min variations in 24-h measurements are shown

> in Fig. 2. The SD

> > and CV for BP were higher in centenarians than in elderly

subjects.

> However, no

> > significant differences in SD or CV of HR were observed between

> elderly subjects and

> > centenarians.

> >

> > FIG. 2. Blood pressure variations every 30 min for 24 h in elderly

> and centennial

> > groups. SD = standard deviation; CV = coefficient of variation;

> other abbreviations

> > as in Fig. 1.

> >

> > The WC effect was associated with SD and CV for 24-h BP in

> centenarians. The WC

> > effect for systolic BP was positively correlated with both SD (r =

> 0.45, P < .01)

> > and CV (r = 0.55, P < .01) of 24-h systolic BP in centenarians,

but

> not in elderly

> > subjects (Fig. 3). However, the WC effect for diastolic BP was

> unrelated to SD or CV

> > of 24-h diastolic BP in both elderly subjects (SD: r = 0.09, P =

> .352; CV: r = 0.06,

> > P = .253) and centenarians (SD: r = 0.13, P = .113; CV: r = 0.15,

P

> = .082).

> >

> > Discussion

> >

> > ...Centenarians and WC Hypertension

> >

> > In the Hotan region, an area densely populated by Uygurs, the

> proportion of

> > centenarians in the population is 18.9/100,000.4 The Uygurs in

> Xinjiang, China, are

> > particularly long-lived. Extreme longevity in humans seems to be

> associated with

> > numerous factors. In the present study, incidence of hypertension

> was lower in

> > elderly Uygur subjects (65- to 70-year-old) than in the general

> Chinese elderly

> > population. Prevalence of hypertension differs according to

> ethnicity in China, but

> > averages 13.58% in the general population and 32% to 49% in

elderly

> subjects.13 and

> > 14 Uygur elderly subjects, presenting as less hypertensive, may

> represent the best

> > candidates for becoming centenarians.

> >

> > Although aged individuals are typically thought to display reduced

> response to

> > stressors, WC hypertension in the present study was greater in

> centenarians than in

> > elderly subjects. Supporting this finding, another study has shown

> that office BP

> > was higher than mean 24-h BP values in centenarians (N = 11).5

> However, the WC

> > effect and WC hypertension were not shown in centenarians in that

> study. A small

> > number of studies in older subjects have suggested that clinic BP

is

> greater than

> > ambulatory BP, and this difference between clinic and ambulatory

BP

> increases with

> > age,7 and 8 although subjects in those studies were <80 years

old. A

> contrasting

> > report shows that BP variation increases with age, particularly

> after 60 years

> > old.15 However, no centenarians were investigated in that study.

In

> our study, WC

> > hypertension was more prevalent in centenarians than in elderly

> subjects, indicating

> > that prevalence of hypertension in centenarians might differ from

> that in other

> > elderly populations.

> >

> > The phenomenon of WC hypertension may reflect an abnormally

vigorous

> sympathetic

> > nerve response to the measurement environment, particularly in the

> presence of the

> > measuring nurse or physician. However, in the present study, ABPM

> was conducted in

> > all subjects at the same period and in the same environment, and

> frequency and time

> > of office visits were similar between elderly and centenarian

> subjects. However,

> > research has shown that BP reactions to measurements by clinical

> staff are

> > associated with enhanced BP responses to mental stress testing.16

In

> contrast,

> > Parati et al17 found that mental laboratory stressors did not

> correlate with

> > increases in BP accompanying a visit by a physician. Conflicting

> results exist on

> > whether patients with WC hypertension are more susceptible to

mental

> stress than

> > normal subjects.

> >

> > In the present study, despite increases in both clinical and

> ambulatory BP in

> > centenarians, the WC effect was obviously greater for systolic

than

> for diastolic BP

> > or HR, indicating that arterial arteriosclerosis might be

progressed

> and responsive

> > to minimal stressors. Centenarians in the present study

demonstrated

> a sharp

> > increase in PP and increased prevalence of isolated systolic

> hypertension, revealing

> > that arterial vessels might be " reactive " for given stimuli.

> Therefore, high

> > responsiveness may be due to a higher level of adaptive

morphologic

> changes in

> > thickened vascular walls.

> >

> > BP Variation

> >

> > In the present study, the same day–night definition was used

> for all

> subjects.

> > However, night-time systolic BP was higher in centenarians than in

> elderly subjects.

> > One study has shown that reduced nocturnal BP declines in the very

> elderly,

> > particularly in women.18 Another study indicated the flatted

> circadian pattern of BP

> > involves activity, sleeping quality, and arteriosclerosis.19 In

the

> present study,

> > centenarians also displayed high night-time systolic BP, and

> presented a

> > nondipper-type of circadian pattern. Decreased compliance of the

> large elastic

> > arteries in centenarians may lead to disturbance of baroreceptor

> reflex function, in

> > turn resulting in increased variability of BP, for systolic BP in

> particular.

> >

> > Centenarians in this study demonstrated higher SDs and CVs

compared

> to elderly

> > subjects, and the WC effect correlated with BP variations. The BP

> variation may

> > represent one of the factors affecting the WC effect in

> centenarians, and might

> > involve reduced function of cardiac and vascular modulation

systems

> that control

> > cardiovascular variation. An earlier study has shown that BP

> variability may also

> > represent an increased risk factor, given an association with

> impaired arterial

> > distensibility.20 Centenarians might thus be at higher risk of

> cardiovascular

> > disease and mortality because of their advanced age. ...

> >

> > ...

> >

> > Al Pater, PhD; email: old542000@y...

[Guest guest]

Hi folks:

It would be even more interesting to know what the BMIs and blood

pressures of these centenarians had been during the course of their

lives. Neither of these numbers is necessarily fixed. Many older

people lose weight as they age. Some also shrink vertically as well,

affecting BMI even if their weight doesn't change. What were these

people's BMIs and BPs when they were 40? Or 60? Or 80?

Nevertheless those data do provide one important piece of the puzzle.

Rodney.

> > Hi All,

> > A new paper on centenarian blood pressure has been published. It

> examines a

> > particularly longevous population for the level of blood pressure

> among its

> > centenarians, compared with much less elderly members of the same

> population. It is

> > described in partial detail below from its similarly available

> full-text.

> >

> > Am J Hypertens. 2005 Aug;18(8):1040-5.

> > White coat hypertension in centenarians.

> > Jumabay M, Ozawa Y, Kawamura H, Saito S, Izumi Y, Mitsubayashi H,

> Kasamaki Y,

> > Nakayama T, Cheng Z, Ma Y, Mahumut M.

> > BACKGROUND: To study white coat (WC) hypertension in

> centenarians, a

> > cross-sectional surveillance was carried out on Uygurs, a long-

lived

> population in

> > China. METHODS: Twenty-four-hour ambulatory blood pressure (BP)

> monitoring (ABPM)

> > was performed in 33 centenarians (age range, 100 to 113 years) and

> compared with 100

> > elderly subjects (age range, 65 to 70 years). All subjects were

> clinically healthy

> > and capable of self-care. Subjects had no history, signs, or

> symptoms of

> > cardiovascular disease and were receiving no medical treatments.

> Office BP, 24-h

> > mean, daytime and night-time BP, pulse pressure, heart rate,

> standard deviation

> > (SD), and coefficient of variation (CV) of the same variables were

> extracted from

> > ABPM. The WC effect was defined as the difference between mean

> office and daytime

> > BP. RESULTS: Centenarians demonstrated higher prevalence of WC

> hypertension,

> > compared to elderly group (15% vs. 5%). The WC effect was also

> greater in

> > centenarians than in elderly subjects, and was more marked for

> systolic BP than for

> > diastolic BP and heart rate. The WC effect for systolic BP was

> positively correlated

> > with both SD (r = 0.45, P < .01) and CV (r = 0.55, P < .01) for

24-h

> systolic BP in

> > centenarians, but not in elderly subjects. CONCLUSIONS: Prevalence

> of WC

> > hypertension was greater in centenarians than in elderly subjects.

> The WC effect and

> > BP variation may be increased in centenarians. Previously observed

> higher BPs seen

> > in very elderly individuals might be explained by the greater

impact

> of WC

> > hypertension. PMID: 16109317

> >

> > ... Results

> >

> > Physiologic Characteristics of Subjects

> >

> > ... Table 1. Physiologic characteristics of subjects

> > .....................................

> > Elderly (n = 100) Centenarian (n = 33)

> > .....................................

> > ------Men/women 66/34 25/8

> > Age (y)

> > Men 68±2.0 104±5

> > Women 67±2.0 104±3

> > Height (cm)

> > Men 160±5.7 154±12 †

> > Women 149±4.7 148±6.9

> > Weight (kg)

> > Men 55±5.8 53±6.6 †

> > Women 46±6.7 40±5.6 †

> > BMI (kg/m2)

> > Men 21±1.9 21±3.3

> > Women 21±2.8 18±1.9

> > ...................................

> > BMI = body mass index.

> > Values are means±SD.

> > †P < .01, differences between the elderly and centenarian

> groups.

> >

> > ... Table 2. White coat effect

> > ...................................

> > ----Elderly (n = 100) Centenarian (n = 33)

> > ...................................

> > Office

> > SBP (mm Hg) 128±10.3 145±10.1 †

> > DBP (mm Hg) 74±5.8 85±6.9 †

> > HR (beats/min) 83±3.3 82±5.1

> > Daytime

> > SBP (mm Hg) 123±17 129±22 †

> > DBP (mm Hg) 72±7.2 74±11

> > HR (beats/min) 80±8.5 79±11

> > White coat effect

> > SBP (mm Hg) 15±11.9 19±8.8 †

> > DBP (mm Hg) 10±8.1 12±5.1

> > HR (beats/min) 10±5.7 11±6.0

> > .....................................

> > SBP = systolic blood pressure; DBP = diastolic blood pressure; HR

=

> heart rate.

> > Values are means±SD.

> > †P < .01, differences between the elderly and centenarian

> groups.

> >

> > ... Table 3. Blood pressure and pulse rate on ambulatory

monitoring

> > ...................................

> > ----Elderly (n = 100) Centenarian (n = 33)

> > ...................................

> > Mean 24-h

> > SBP (mm Hg) 121±16 128±23 †

> > DBP (mm Hg) 72±6.8 71±12

> > PP (mm Hg) 45±21 60±15 †

> > HR (beats/min) 78±8.9 76±11

> > Daytime

> > SBP (mm Hg) 123±17 129±22 †

> > DBP (mm Hg) 72±7.2 74±11

> > HR (beats/min) 80±8.5 79±11

> > Night-time

> > SBP (mm Hg) 117±18 127±20 †

> > DBP (mm Hg) 68±7 70±14

> > HR (beats/min) 71±12 71±13

> > Daytime–night-time

> > SBP (mm Hg) 9.5±7.4 1.7±1.2 †

> > DBP (mm Hg) 2.8±1.5 2.6±1.1

> > HR (beats/min) 10.6±5.5 9.5±7.1

> > ......................................

> > Abbreviations as in Table 2; PP = pulse pressure.

> > Values are means±SD.

> > †P < .01, differences between the elderly and centenarian

> groups.

> >

> > Circadian BP and HR profiles are shown in Fig. 1. Two peaks and

one

> dip pattern

> > characterized circadian systolic BP in elderly subjects. Circadian

> variations in

> > systolic BP showed multiple peaks, and the overall pattern tended

to

> be flatter in

> > centenarians. However, circadian patterns for HR were similar

> between centenarians

> > and elderly subjects.

> >

> > The SD and CV for 30-min variations in 24-h measurements are shown

> in Fig. 2. The SD

> > and CV for BP were higher in centenarians than in elderly

subjects.

> However, no

> > significant differences in SD or CV of HR were observed between

> elderly subjects and

> > centenarians.

> >

> > FIG. 2. Blood pressure variations every 30 min for 24 h in elderly

> and centennial

> > groups. SD = standard deviation; CV = coefficient of variation;

> other abbreviations

> > as in Fig. 1.

> >

> > The WC effect was associated with SD and CV for 24-h BP in

> centenarians. The WC

> > effect for systolic BP was positively correlated with both SD (r =

> 0.45, P < .01)

> > and CV (r = 0.55, P < .01) of 24-h systolic BP in centenarians,

but

> not in elderly

> > subjects (Fig. 3). However, the WC effect for diastolic BP was

> unrelated to SD or CV

> > of 24-h diastolic BP in both elderly subjects (SD: r = 0.09, P =

> .352; CV: r = 0.06,

> > P = .253) and centenarians (SD: r = 0.13, P = .113; CV: r = 0.15,

P

> = .082).

> >

> > Discussion

> >

> > ...Centenarians and WC Hypertension

> >

> > In the Hotan region, an area densely populated by Uygurs, the

> proportion of

> > centenarians in the population is 18.9/100,000.4 The Uygurs in

> Xinjiang, China, are

> > particularly long-lived. Extreme longevity in humans seems to be

> associated with

> > numerous factors. In the present study, incidence of hypertension

> was lower in

> > elderly Uygur subjects (65- to 70-year-old) than in the general

> Chinese elderly

> > population. Prevalence of hypertension differs according to

> ethnicity in China, but

> > averages 13.58% in the general population and 32% to 49% in

elderly

> subjects.13 and

> > 14 Uygur elderly subjects, presenting as less hypertensive, may

> represent the best

> > candidates for becoming centenarians.

> >

> > Although aged individuals are typically thought to display reduced

> response to

> > stressors, WC hypertension in the present study was greater in

> centenarians than in

> > elderly subjects. Supporting this finding, another study has shown

> that office BP

> > was higher than mean 24-h BP values in centenarians (N = 11).5

> However, the WC

> > effect and WC hypertension were not shown in centenarians in that

> study. A small

> > number of studies in older subjects have suggested that clinic BP

is

> greater than

> > ambulatory BP, and this difference between clinic and ambulatory

BP

> increases with

> > age,7 and 8 although subjects in those studies were <80 years

old. A

> contrasting

> > report shows that BP variation increases with age, particularly

> after 60 years

> > old.15 However, no centenarians were investigated in that study.

In

> our study, WC

> > hypertension was more prevalent in centenarians than in elderly

> subjects, indicating

> > that prevalence of hypertension in centenarians might differ from

> that in other

> > elderly populations.

> >

> > The phenomenon of WC hypertension may reflect an abnormally

vigorous

> sympathetic

> > nerve response to the measurement environment, particularly in the

> presence of the

> > measuring nurse or physician. However, in the present study, ABPM

> was conducted in

> > all subjects at the same period and in the same environment, and

> frequency and time

> > of office visits were similar between elderly and centenarian

> subjects. However,

> > research has shown that BP reactions to measurements by clinical

> staff are

> > associated with enhanced BP responses to mental stress testing.16

In

> contrast,

> > Parati et al17 found that mental laboratory stressors did not

> correlate with

> > increases in BP accompanying a visit by a physician. Conflicting

> results exist on

> > whether patients with WC hypertension are more susceptible to

mental

> stress than

> > normal subjects.

> >

> > In the present study, despite increases in both clinical and

> ambulatory BP in

> > centenarians, the WC effect was obviously greater for systolic

than

> for diastolic BP

> > or HR, indicating that arterial arteriosclerosis might be

progressed

> and responsive

> > to minimal stressors. Centenarians in the present study

demonstrated

> a sharp

> > increase in PP and increased prevalence of isolated systolic

> hypertension, revealing

> > that arterial vessels might be " reactive " for given stimuli.

> Therefore, high

> > responsiveness may be due to a higher level of adaptive

morphologic

> changes in

> > thickened vascular walls.

> >

> > BP Variation

> >

> > In the present study, the same day–night definition was used

> for all

> subjects.

> > However, night-time systolic BP was higher in centenarians than in

> elderly subjects.

> > One study has shown that reduced nocturnal BP declines in the very

> elderly,

> > particularly in women.18 Another study indicated the flatted

> circadian pattern of BP

> > involves activity, sleeping quality, and arteriosclerosis.19 In

the

> present study,

> > centenarians also displayed high night-time systolic BP, and

> presented a

> > nondipper-type of circadian pattern. Decreased compliance of the

> large elastic

> > arteries in centenarians may lead to disturbance of baroreceptor

> reflex function, in

> > turn resulting in increased variability of BP, for systolic BP in

> particular.

> >

> > Centenarians in this study demonstrated higher SDs and CVs

compared

> to elderly

> > subjects, and the WC effect correlated with BP variations. The BP

> variation may

> > represent one of the factors affecting the WC effect in

> centenarians, and might

> > involve reduced function of cardiac and vascular modulation

systems

> that control

> > cardiovascular variation. An earlier study has shown that BP

> variability may also

> > represent an increased risk factor, given an association with

> impaired arterial

> > distensibility.20 Centenarians might thus be at higher risk of

> cardiovascular

> > disease and mortality because of their advanced age. ...

> >

> > ...

> >

> > Al Pater, PhD; email: old542000@y...

[Guest guest]

> > > Hi All,

> > > A new paper on centenarian blood pressure has been published.

It

> > examines a

> > > particularly longevous population for the level of blood

pressure

> > among its

> > > centenarians, compared with much less elderly members of the

same

> > population. It is

> > > described in partial detail below from its similarly available

> > full-text.

> > >

> > > Am J Hypertens. 2005 Aug;18(8):1040-5.

> > > White coat hypertension in centenarians.

> > > Jumabay M, Ozawa Y, Kawamura H, Saito S, Izumi Y, Mitsubayashi

H,

> > Kasamaki Y,

> > > Nakayama T, Cheng Z, Ma Y, Mahumut M.

> > > BACKGROUND: To study white coat (WC) hypertension in

> > centenarians, a

> > > cross-sectional surveillance was carried out on Uygurs, a long-

> lived

> > population in

> > > China. METHODS: Twenty-four-hour ambulatory blood pressure (BP)

> > monitoring (ABPM)

> > > was performed in 33 centenarians (age range, 100 to 113 years)

and

> > compared with 100

> > > elderly subjects (age range, 65 to 70 years). All subjects were

> > clinically healthy

> > > and capable of self-care. Subjects had no history, signs, or

> > symptoms of

> > > cardiovascular disease and were receiving no medical treatments.

> > Office BP, 24-h

> > > mean, daytime and night-time BP, pulse pressure, heart rate,

> > standard deviation

> > > (SD), and coefficient of variation (CV) of the same variables

were

> > extracted from

> > > ABPM. The WC effect was defined as the difference between mean

> > office and daytime

> > > BP. RESULTS: Centenarians demonstrated higher prevalence of WC

> > hypertension,

> > > compared to elderly group (15% vs. 5%). The WC effect was also

> > greater in

> > > centenarians than in elderly subjects, and was more marked for

> > systolic BP than for

> > > diastolic BP and heart rate. The WC effect for systolic BP was

> > positively correlated

> > > with both SD (r = 0.45, P < .01) and CV (r = 0.55, P < .01) for

> 24-h

> > systolic BP in

> > > centenarians, but not in elderly subjects. CONCLUSIONS:

Prevalence

> > of WC

> > > hypertension was greater in centenarians than in elderly

subjects.

> > The WC effect and

> > > BP variation may be increased in centenarians. Previously

observed

> > higher BPs seen

> > > in very elderly individuals might be explained by the greater

> impact

> > of WC

> > > hypertension. PMID: 16109317

> > >

> > > ... Results

> > >

> > > Physiologic Characteristics of Subjects

> > >

> > > ... Table 1. Physiologic characteristics of subjects

> > > .....................................

> > > Elderly (n = 100) Centenarian (n = 33)

> > > .....................................

> > > ------Men/women 66/34 25/8

> > > Age (y)

> > > Men 68±2.0 104±5

> > > Women 67±2.0 104±3

> > > Height (cm)

> > > Men 160±5.7 154±12 †

> > > Women 149±4.7 148±6.9

> > > Weight (kg)

> > > Men 55±5.8 53±6.6 †

> > > Women 46±6.7 40±5.6 †

> > > BMI (kg/m2)

> > > Men 21±1.9 21±3.3

> > > Women 21±2.8 18±1.9

> > > ...................................

> > > BMI = body mass index.

> > > Values are means±SD.

> > > †P < .01, differences between the elderly and centenarian

> > groups.

> > >

> > > ... Table 2. White coat effect

> > > ...................................

> > > ----Elderly (n = 100) Centenarian (n = 33)

> > > ...................................

> > > Office

> > > SBP (mm Hg) 128±10.3 145±10.1 †

> > > DBP (mm Hg) 74±5.8 85±6.9 †

> > > HR (beats/min) 83±3.3 82±5.1

> > > Daytime

> > > SBP (mm Hg) 123±17 129±22 †

> > > DBP (mm Hg) 72±7.2 74±11

> > > HR (beats/min) 80±8.5 79±11

> > > White coat effect

> > > SBP (mm Hg) 15±11.9 19±8.8 †

> > > DBP (mm Hg) 10±8.1 12±5.1

> > > HR (beats/min) 10±5.7 11±6.0

> > > .....................................

> > > SBP = systolic blood pressure; DBP = diastolic blood pressure;

HR

> =

> > heart rate.

> > > Values are means±SD.

> > > †P < .01, differences between the elderly and centenarian

> > groups.

> > >

> > > ... Table 3. Blood pressure and pulse rate on ambulatory

> monitoring

> > > ...................................

> > > ----Elderly (n = 100) Centenarian (n = 33)

> > > ...................................

> > > Mean 24-h

> > > SBP (mm Hg) 121±16 128±23 †

> > > DBP (mm Hg) 72±6.8 71±12

> > > PP (mm Hg) 45±21 60±15 †

> > > HR (beats/min) 78±8.9 76±11

> > > Daytime

> > > SBP (mm Hg) 123±17 129±22 †

> > > DBP (mm Hg) 72±7.2 74±11

> > > HR (beats/min) 80±8.5 79±11

> > > Night-time

> > > SBP (mm Hg) 117±18 127±20 †

> > > DBP (mm Hg) 68±7 70±14

> > > HR (beats/min) 71±12 71±13

> > > Daytime–night-time

> > > SBP (mm Hg) 9.5±7.4 1.7±1.2 †

> > > DBP (mm Hg) 2.8±1.5 2.6±1.1

> > > HR (beats/min) 10.6±5.5 9.5±7.1

> > > ......................................

> > > Abbreviations as in Table 2; PP = pulse pressure.

> > > Values are means±SD.

> > > †P < .01, differences between the elderly and centenarian

> > groups.

> > >

> > > Circadian BP and HR profiles are shown in Fig. 1. Two peaks and

> one

> > dip pattern

> > > characterized circadian systolic BP in elderly subjects.

Circadian

> > variations in

> > > systolic BP showed multiple peaks, and the overall pattern

tended

> to

> > be flatter in

> > > centenarians. However, circadian patterns for HR were similar

> > between centenarians

> > > and elderly subjects.

> > >

> > > The SD and CV for 30-min variations in 24-h measurements are

shown

> > in Fig. 2. The SD

> > > and CV for BP were higher in centenarians than in elderly

> subjects.

> > However, no

> > > significant differences in SD or CV of HR were observed between

> > elderly subjects and

> > > centenarians.

> > >

> > > FIG. 2. Blood pressure variations every 30 min for 24 h in

elderly

> > and centennial

> > > groups. SD = standard deviation; CV = coefficient of variation;

> > other abbreviations

> > > as in Fig. 1.

> > >

> > > The WC effect was associated with SD and CV for 24-h BP in

> > centenarians. The WC

> > > effect for systolic BP was positively correlated with both SD

(r =

> > 0.45, P < .01)

> > > and CV (r = 0.55, P < .01) of 24-h systolic BP in centenarians,

> but

> > not in elderly

> > > subjects (Fig. 3). However, the WC effect for diastolic BP was

> > unrelated to SD or CV

> > > of 24-h diastolic BP in both elderly subjects (SD: r = 0.09, P =

> > .352; CV: r = 0.06,

> > > P = .253) and centenarians (SD: r = 0.13, P = .113; CV: r =

0.15,

> P

> > = .082).

> > >

> > > Discussion

> > >

> > > ...Centenarians and WC Hypertension

> > >

> > > In the Hotan region, an area densely populated by Uygurs, the

> > proportion of

> > > centenarians in the population is 18.9/100,000.4 The Uygurs in

> > Xinjiang, China, are

> > > particularly long-lived. Extreme longevity in humans seems to be

> > associated with

> > > numerous factors. In the present study, incidence of

hypertension

> > was lower in

> > > elderly Uygur subjects (65- to 70-year-old) than in the general

> > Chinese elderly

> > > population. Prevalence of hypertension differs according to

> > ethnicity in China, but

> > > averages 13.58% in the general population and 32% to 49% in

> elderly

> > subjects.13 and

> > > 14 Uygur elderly subjects, presenting as less hypertensive, may

> > represent the best

> > > candidates for becoming centenarians.

> > >

> > > Although aged individuals are typically thought to display

reduced

> > response to

> > > stressors, WC hypertension in the present study was greater in

> > centenarians than in

> > > elderly subjects. Supporting this finding, another study has

shown

> > that office BP

> > > was higher than mean 24-h BP values in centenarians (N = 11).5

> > However, the WC

> > > effect and WC hypertension were not shown in centenarians in

that

> > study. A small

> > > number of studies in older subjects have suggested that clinic

BP

> is

> > greater than

> > > ambulatory BP, and this difference between clinic and

ambulatory

> BP

> > increases with

> > > age,7 and 8 although subjects in those studies were <80 years

> old. A

> > contrasting

> > > report shows that BP variation increases with age, particularly

> > after 60 years

> > > old.15 However, no centenarians were investigated in that

study.

> In

> > our study, WC

> > > hypertension was more prevalent in centenarians than in elderly

> > subjects, indicating

> > > that prevalence of hypertension in centenarians might differ

from

> > that in other

> > > elderly populations.

> > >

> > > The phenomenon of WC hypertension may reflect an abnormally

> vigorous

> > sympathetic

> > > nerve response to the measurement environment, particularly in

the

> > presence of the

> > > measuring nurse or physician. However, in the present study,

ABPM

> > was conducted in

> > > all subjects at the same period and in the same environment, and

> > frequency and time

> > > of office visits were similar between elderly and centenarian

> > subjects. However,

> > > research has shown that BP reactions to measurements by clinical

> > staff are

> > > associated with enhanced BP responses to mental stress

testing.16

> In

> > contrast,

> > > Parati et al17 found that mental laboratory stressors did not

> > correlate with

> > > increases in BP accompanying a visit by a physician. Conflicting

> > results exist on

> > > whether patients with WC hypertension are more susceptible to

> mental

> > stress than

> > > normal subjects.

> > >

> > > In the present study, despite increases in both clinical and

> > ambulatory BP in

> > > centenarians, the WC effect was obviously greater for systolic

> than

> > for diastolic BP

> > > or HR, indicating that arterial arteriosclerosis might be

> progressed

> > and responsive

> > > to minimal stressors. Centenarians in the present study

> demonstrated

> > a sharp

> > > increase in PP and increased prevalence of isolated systolic

> > hypertension, revealing

> > > that arterial vessels might be " reactive " for given stimuli.

> > Therefore, high

> > > responsiveness may be due to a higher level of adaptive

> morphologic

> > changes in

> > > thickened vascular walls.

> > >

> > > BP Variation

> > >

> > > In the present study, the same day–night definition was used

> > for all

> > subjects.

> > > However, night-time systolic BP was higher in centenarians than

in

> > elderly subjects.

> > > One study has shown that reduced nocturnal BP declines in the

very

> > elderly,

> > > particularly in women.18 Another study indicated the flatted

> > circadian pattern of BP

> > > involves activity, sleeping quality, and arteriosclerosis.19 In

> the

> > present study,

> > > centenarians also displayed high night-time systolic BP, and

> > presented a

> > > nondipper-type of circadian pattern. Decreased compliance of the

> > large elastic

> > > arteries in centenarians may lead to disturbance of baroreceptor

> > reflex function, in

> > > turn resulting in increased variability of BP, for systolic BP

in

> > particular.

> > >

> > > Centenarians in this study demonstrated higher SDs and CVs

> compared

> > to elderly

> > > subjects, and the WC effect correlated with BP variations. The

BP

> > variation may

> > > represent one of the factors affecting the WC effect in

> > centenarians, and might

> > > involve reduced function of cardiac and vascular modulation

> systems

> > that control

> > > cardiovascular variation. An earlier study has shown that BP

> > variability may also

> > > represent an increased risk factor, given an association with

> > impaired arterial

> > > distensibility.20 Centenarians might thus be at higher risk of

> > cardiovascular

> > > disease and mortality because of their advanced age. ...

> > >

> > > ...

> > >

> > > Al Pater, PhD; email: old542000@y...

[Guest guest]

> > > Hi All,

> > > A new paper on centenarian blood pressure has been published.

It

> > examines a

> > > particularly longevous population for the level of blood

pressure

> > among its

> > > centenarians, compared with much less elderly members of the

same

> > population. It is

> > > described in partial detail below from its similarly available

> > full-text.

> > >

> > > Am J Hypertens. 2005 Aug;18(8):1040-5.

> > > White coat hypertension in centenarians.

> > > Jumabay M, Ozawa Y, Kawamura H, Saito S, Izumi Y, Mitsubayashi

H,

> > Kasamaki Y,

> > > Nakayama T, Cheng Z, Ma Y, Mahumut M.

> > > BACKGROUND: To study white coat (WC) hypertension in

> > centenarians, a

> > > cross-sectional surveillance was carried out on Uygurs, a long-

> lived

> > population in

> > > China. METHODS: Twenty-four-hour ambulatory blood pressure (BP)

> > monitoring (ABPM)

> > > was performed in 33 centenarians (age range, 100 to 113 years)

and

> > compared with 100

> > > elderly subjects (age range, 65 to 70 years). All subjects were

> > clinically healthy

> > > and capable of self-care. Subjects had no history, signs, or

> > symptoms of

> > > cardiovascular disease and were receiving no medical treatments.

> > Office BP, 24-h

> > > mean, daytime and night-time BP, pulse pressure, heart rate,

> > standard deviation

> > > (SD), and coefficient of variation (CV) of the same variables

were

> > extracted from

> > > ABPM. The WC effect was defined as the difference between mean

> > office and daytime

> > > BP. RESULTS: Centenarians demonstrated higher prevalence of WC

> > hypertension,

> > > compared to elderly group (15% vs. 5%). The WC effect was also

> > greater in

> > > centenarians than in elderly subjects, and was more marked for

> > systolic BP than for

> > > diastolic BP and heart rate. The WC effect for systolic BP was

> > positively correlated

> > > with both SD (r = 0.45, P < .01) and CV (r = 0.55, P < .01) for

> 24-h

> > systolic BP in

> > > centenarians, but not in elderly subjects. CONCLUSIONS:

Prevalence

> > of WC

> > > hypertension was greater in centenarians than in elderly

subjects.

> > The WC effect and

> > > BP variation may be increased in centenarians. Previously

observed

> > higher BPs seen

> > > in very elderly individuals might be explained by the greater

> impact

> > of WC

> > > hypertension. PMID: 16109317

> > >

> > > ... Results

> > >

> > > Physiologic Characteristics of Subjects

> > >

> > > ... Table 1. Physiologic characteristics of subjects

> > > .....................................

> > > Elderly (n = 100) Centenarian (n = 33)

> > > .....................................

> > > ------Men/women 66/34 25/8

> > > Age (y)

> > > Men 68±2.0 104±5

> > > Women 67±2.0 104±3

> > > Height (cm)

> > > Men 160±5.7 154±12 †

> > > Women 149±4.7 148±6.9

> > > Weight (kg)

> > > Men 55±5.8 53±6.6 †

> > > Women 46±6.7 40±5.6 †

> > > BMI (kg/m2)

> > > Men 21±1.9 21±3.3

> > > Women 21±2.8 18±1.9

> > > ...................................

> > > BMI = body mass index.

> > > Values are means±SD.

> > > †P < .01, differences between the elderly and centenarian

> > groups.

> > >

> > > ... Table 2. White coat effect

> > > ...................................

> > > ----Elderly (n = 100) Centenarian (n = 33)

> > > ...................................

> > > Office

> > > SBP (mm Hg) 128±10.3 145±10.1 †

> > > DBP (mm Hg) 74±5.8 85±6.9 †

> > > HR (beats/min) 83±3.3 82±5.1

> > > Daytime

> > > SBP (mm Hg) 123±17 129±22 †

> > > DBP (mm Hg) 72±7.2 74±11

> > > HR (beats/min) 80±8.5 79±11

> > > White coat effect

> > > SBP (mm Hg) 15±11.9 19±8.8 †

> > > DBP (mm Hg) 10±8.1 12±5.1

> > > HR (beats/min) 10±5.7 11±6.0

> > > .....................................

> > > SBP = systolic blood pressure; DBP = diastolic blood pressure;

HR

> =

> > heart rate.

> > > Values are means±SD.

> > > †P < .01, differences between the elderly and centenarian

> > groups.

> > >

> > > ... Table 3. Blood pressure and pulse rate on ambulatory

> monitoring

> > > ...................................

> > > ----Elderly (n = 100) Centenarian (n = 33)

> > > ...................................

> > > Mean 24-h

> > > SBP (mm Hg) 121±16 128±23 †

> > > DBP (mm Hg) 72±6.8 71±12

> > > PP (mm Hg) 45±21 60±15 †

> > > HR (beats/min) 78±8.9 76±11

> > > Daytime

> > > SBP (mm Hg) 123±17 129±22 †

> > > DBP (mm Hg) 72±7.2 74±11

> > > HR (beats/min) 80±8.5 79±11

> > > Night-time

> > > SBP (mm Hg) 117±18 127±20 †

> > > DBP (mm Hg) 68±7 70±14

> > > HR (beats/min) 71±12 71±13

> > > Daytime–night-time

> > > SBP (mm Hg) 9.5±7.4 1.7±1.2 †

> > > DBP (mm Hg) 2.8±1.5 2.6±1.1

> > > HR (beats/min) 10.6±5.5 9.5±7.1

> > > ......................................

> > > Abbreviations as in Table 2; PP = pulse pressure.

> > > Values are means±SD.

> > > †P < .01, differences between the elderly and centenarian

> > groups.

> > >

> > > Circadian BP and HR profiles are shown in Fig. 1. Two peaks and

> one

> > dip pattern

> > > characterized circadian systolic BP in elderly subjects.

Circadian

> > variations in

> > > systolic BP showed multiple peaks, and the overall pattern

tended

> to

> > be flatter in

> > > centenarians. However, circadian patterns for HR were similar

> > between centenarians

> > > and elderly subjects.

> > >

> > > The SD and CV for 30-min variations in 24-h measurements are

shown

> > in Fig. 2. The SD

> > > and CV for BP were higher in centenarians than in elderly

> subjects.

> > However, no

> > > significant differences in SD or CV of HR were observed between

> > elderly subjects and

> > > centenarians.

> > >

> > > FIG. 2. Blood pressure variations every 30 min for 24 h in

elderly

> > and centennial

> > > groups. SD = standard deviation; CV = coefficient of variation;

> > other abbreviations

> > > as in Fig. 1.

> > >

> > > The WC effect was associated with SD and CV for 24-h BP in

> > centenarians. The WC

> > > effect for systolic BP was positively correlated with both SD

(r =

> > 0.45, P < .01)

> > > and CV (r = 0.55, P < .01) of 24-h systolic BP in centenarians,

> but

> > not in elderly

> > > subjects (Fig. 3). However, the WC effect for diastolic BP was

> > unrelated to SD or CV

> > > of 24-h diastolic BP in both elderly subjects (SD: r = 0.09, P =

> > .352; CV: r = 0.06,

> > > P = .253) and centenarians (SD: r = 0.13, P = .113; CV: r =

0.15,

> P

> > = .082).

> > >

> > > Discussion

> > >

> > > ...Centenarians and WC Hypertension

> > >

> > > In the Hotan region, an area densely populated by Uygurs, the

> > proportion of

> > > centenarians in the population is 18.9/100,000.4 The Uygurs in

> > Xinjiang, China, are

> > > particularly long-lived. Extreme longevity in humans seems to be

> > associated with

> > > numerous factors. In the present study, incidence of

hypertension

> > was lower in

> > > elderly Uygur subjects (65- to 70-year-old) than in the general

> > Chinese elderly

> > > population. Prevalence of hypertension differs according to

> > ethnicity in China, but

> > > averages 13.58% in the general population and 32% to 49% in

> elderly

> > subjects.13 and

> > > 14 Uygur elderly subjects, presenting as less hypertensive, may

> > represent the best

> > > candidates for becoming centenarians.

> > >

> > > Although aged individuals are typically thought to display

reduced

> > response to

> > > stressors, WC hypertension in the present study was greater in

> > centenarians than in

> > > elderly subjects. Supporting this finding, another study has

shown

> > that office BP

> > > was higher than mean 24-h BP values in centenarians (N = 11).5

> > However, the WC

> > > effect and WC hypertension were not shown in centenarians in

that

> > study. A small

> > > number of studies in older subjects have suggested that clinic

BP

> is

> > greater than

> > > ambulatory BP, and this difference between clinic and

ambulatory

> BP

> > increases with

> > > age,7 and 8 although subjects in those studies were <80 years

> old. A

> > contrasting

> > > report shows that BP variation increases with age, particularly

> > after 60 years

> > > old.15 However, no centenarians were investigated in that

study.

> In

> > our study, WC

> > > hypertension was more prevalent in centenarians than in elderly

> > subjects, indicating

> > > that prevalence of hypertension in centenarians might differ

from

> > that in other

> > > elderly populations.

> > >

> > > The phenomenon of WC hypertension may reflect an abnormally

> vigorous

> > sympathetic

> > > nerve response to the measurement environment, particularly in

the

> > presence of the

> > > measuring nurse or physician. However, in the present study,

ABPM

> > was conducted in

> > > all subjects at the same period and in the same environment, and

> > frequency and time

> > > of office visits were similar between elderly and centenarian

> > subjects. However,

> > > research has shown that BP reactions to measurements by clinical

> > staff are

> > > associated with enhanced BP responses to mental stress

testing.16

> In

> > contrast,

> > > Parati et al17 found that mental laboratory stressors did not

> > correlate with

> > > increases in BP accompanying a visit by a physician. Conflicting

> > results exist on

> > > whether patients with WC hypertension are more susceptible to

> mental

> > stress than

> > > normal subjects.

> > >

> > > In the present study, despite increases in both clinical and

> > ambulatory BP in

> > > centenarians, the WC effect was obviously greater for systolic

> than

> > for diastolic BP

> > > or HR, indicating that arterial arteriosclerosis might be

> progressed

> > and responsive

> > > to minimal stressors. Centenarians in the present study

> demonstrated

> > a sharp

> > > increase in PP and increased prevalence of isolated systolic

> > hypertension, revealing

> > > that arterial vessels might be " reactive " for given stimuli.

> > Therefore, high

> > > responsiveness may be due to a higher level of adaptive

> morphologic

> > changes in

> > > thickened vascular walls.

> > >

> > > BP Variation

> > >

> > > In the present study, the same day–night definition was used

> > for all

> > subjects.

> > > However, night-time systolic BP was higher in centenarians than

in

> > elderly subjects.

> > > One study has shown that reduced nocturnal BP declines in the

very

> > elderly,

> > > particularly in women.18 Another study indicated the flatted

> > circadian pattern of BP

> > > involves activity, sleeping quality, and arteriosclerosis.19 In

> the

> > present study,

> > > centenarians also displayed high night-time systolic BP, and

> > presented a

> > > nondipper-type of circadian pattern. Decreased compliance of the

> > large elastic

> > > arteries in centenarians may lead to disturbance of baroreceptor

> > reflex function, in

> > > turn resulting in increased variability of BP, for systolic BP

in

> > particular.

> > >

> > > Centenarians in this study demonstrated higher SDs and CVs

> compared

> > to elderly

> > > subjects, and the WC effect correlated with BP variations. The

BP

> > variation may

> > > represent one of the factors affecting the WC effect in

> > centenarians, and might

> > > involve reduced function of cardiac and vascular modulation

> systems

> > that control

> > > cardiovascular variation. An earlier study has shown that BP

> > variability may also

> > > represent an increased risk factor, given an association with

> > impaired arterial

> > > distensibility.20 Centenarians might thus be at higher risk of

> > cardiovascular

> > > disease and mortality because of their advanced age. ...

> > >

> > > ...

> > >

> > > Al Pater, PhD; email: old542000@y...