Blood pressure

Blood pressure


LASA151

Contact: Natasja van Schoor

Background
Blood pressure is often measured for clinical purposes. High blood pressure (hypertension) is a predictor for mortality and cardiovascular morbidity [1].

Blood pressure can be measured at several places of the body. Most often it is measured at the upper arm and both systolic and diastolic blood pressure is recorded.

During the whole cycle of a heartbeat, the blood pressure varies between the systolic pressure (the highest pressure) and the diastolic pressure (the lowest pressure). The blood pressure is generated by the pump function of the heart.

Nowadays, the discussion on the definition of high blood pressure, hypertension, is still ongoing. Latest guidelines from the Dutch society for general practitioners defined a high blood pressure as a systolic pressure >140 mmHg and/or a diastolic pressure >90 mmHg [2]. For older persons (>80 years of age) higher target values are recommended (systolic blood pressure 150-160 mmHg) [2].

Measurement instruments in LASA
Blood pressure in LASA was measured at the upper arm in all cycles, except for the B-cycle in which measurements were performed at the finger, using an automatic Omron device (Omron HEM 815F). In LASA C and D, both finger and upper-arm measurements were done.

Upper-arm measurements were performed using an automatic Omron device. In the C-cycle, the Omron HEM 706 was used, whereas in the MB cohort, the Omron M7 device was used. For the other cycles it has become indistinct which device was used (Omron M7 intelli sense RR meter, Omron HEM 706, or Omron HEM 711, Tokyo, Japan). All measurements were performed at the left arm. When this was not possible, the right arm was used. Participants were not allowed to smoke, eat or be physically active during the last hour before the measurement. Interviewers were trained to follow the generally accepted guidelines for blood pressure measurements, regarding the position of the cuff, arm etc.

When more than one measurement was performed during one cycle, there was significant time between the subsequent measurements.

Questionnaires
Not applicable for this topic

Variable information
LASAB151 / LASAC151 / LASAD151 / LASAE151 / LAS2B151 / LASAF151 / LASAG151 / LASAH151 / LAS3B151 / LASMB151 / LASAI151

Availability of information per wave 1

 

 

B

C

D

E


2B*

F

G

H



3B*

MB*

I*

Blood pressure and pulse rate

Me

Me

Me

Me 

Me

Me

Me

Me

Me

Me 

Me
Place of measurement:                      
Finger 2 Me
(3x)
Me Me                
Arm - sitting   Me Me Me
(3x)
Me
(4x)
Me
(3x)
Me
(4x)
Me
(2x)
Me Me Me
Arm - lying   Me Me                
Arm - standing   Me Me                

 1   More information about the LASA data collection waves is available here.

2  We do not recommend the use of the data from the blood pressure measurements at the finger. A small-scale validation of this measurement against upper-arm measurement using a sphygmomanometer (B-cycle, n=50 respondents) yielded a near-zero correlation (non-published data). In addition, it is definitely not correct to compare the finger measurements of one cycle with the arm measurements of another cycle.

* 2B=baseline second cohort;
   3B=baseline third cohort (data under construction);
   MB=migrants: baseline first cohort
   I=not yet available

Me=data collected in medical interview

 

Previous use in LASA
Because there are differences between the waves in place of measurement and number of measurements, it is necessary to make the decisions regarding data-analyses carefully. For example, the mean of all measurements within a wave can be used or, alternatively, only the first measurement can be used to make it comparable to waves with only one measurement.

Examples of the use of blood pressure measurements can be found in the following articles:

  • Snijder MB, Lips PTA, Seidell JC, Visser M, Deeg DJH, Dekker JM, Van Dam RM. Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population-based study in older men and women. Journal of Internal Medicine, 2007; 261: 558-565.
  • Sohl E, De Jongh RT, Heymans MW, van Schoor NM, Lips PTA. Thresholds for serum 25(OH)D concentrations iwth respect to different outcomes. Jounral of Clinical Endocrinology & Metabolism, 2015;100:2480-2488.

Blood pressure measurements were also used as a parameter of the metabolic syndrome, which was assessed at the C-cycle:

  • Oosterwerff MM, Van Schoor, NM, Lips PTA, Eekhoff EMW. (2013). Osteocalcin as a predictor of the metabolic syndrome in older persons: a population-based study. Clinical Endocrinology, 78, 242-247.
  • Oosterwerff MM, Eekhoff EMW, Heymans MW, Lips PTA, Van Schoor NM. (2011). Serum 25-hydroxyvitamin D levels and the metabolic syndrome in older persons: a population-based study. Clinical Endocrinology, 75, 5, 608-613

References