Blood pressure

Blood pressure

LASA filenames:
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.

The blood pressure is generated by the pump function of the heart. 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).

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, using an automatic Omron device (Omron HEM 815F). In the C-wave (1995-96), the Omron HEM 706 was used, whereas in the MB cohort, the Omron M7 device was used. For the other waves, different devices were used by different nurse-interviewers, and it has become indistinct which device was used for which participant (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 asked not 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 wave, a significant time interval was observed between the subsequent measurements.

Questionnaires
LASAB151 / LASAC151 / LASAD151 / LASAE151 / LAS2B151 / LASAF151 / LASAG151 / LASAH151 / LAS3B151 / LASMB151 / LASAI151 / LASAJ151 / LASAK151 (medical interview, in Dutch)

Variable information
LASAB151 / LASAC151 / LASAD151 / LASAE151 / LAS2B151 / LASAF151 / LASAG151 / LASAH151 / LAS3B151 / LASMB151 / LASAI151 / LASAJ151 / LASAK151
(pdf)

Availability of information per wave ¹

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

* 2B=baseline second cohort;
3B=baseline third cohort;
MB=migrants: baseline first cohort

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-wave and studied in relation to bone health and mental health:

• Dik MG, Jonker C, Comijs HC, Dik MG, Jonker C, Comijs HC, Deeg DJH, Kok A, Yaffe K, Penninx BW. Contribution of Metabolic Syndrome Components to Cognition in Older Individuals. Diabetes Care. 2007; 30(10): 2655-2660.
• 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.
• van Bunderen CC, Oosterwerff M, van Schoor N, Deeg DJ, Lips P, Drent M. Serum Insulin-Like Growth Factor-I, Metabolic Syndrome and Incident Cardiovascular Disease in Older people: A Population-Based Study. Eur J Endocrinol 2013; 168(3): 393-401.
• Vogelzangs N, Beekman AT, Dik MG, Bremmer MA, Comijs HC, Hoogendijk WJ, Deeg DJ, Penninx BW. Late-life depression, cortisol, and the metabolic syndrome. Am J Geriatr Psychiatry 2009; 17(8): 716-21.

References

• Lewington S, Clarke R, Qizilbash N, Peto R, Collins R (2002) Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 360: 1903-13.
• https://www.nhg.org/standaarden/samenvatting/cardiovasculair-risicomanagement#idp15239456, accessed on September 12, 2014.

Date of last update: July, 2020