Centenarian Body Mass Index and blood pressure

[Guest guest]

It was interesting to note that the BMI for centenarians was 21±3.3

for men and 18±1.9 for women. A BMI of 21 is what our files

indicate offers the best protection from CVD, diabetes, and other

diseases. The centenarian men's BMI ranged from 17.7 to 24.3 which

extends slightly below the " normal " BMI range (18.5 to 24.9). It was

surprising that centenarian women had BMIs around 18 and that a

substantial part of the range of 16.1 to 19.9 is below normal.

Some of our recent posts about blood pressure have indicated concern

about moderate hypertension which is considered to be a systolic BP

exceeding 120 mm Hg. However, centenarians had BPs with average

systolic daytime values of 129±22.

It seems that moderately high blood pressure is not an impediment to

longevity. 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. 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...