English summary: SYSTOLIC BLOOD PRESSURE, RISK OF DEATH, AND QUALITY OF LIFE IN OLD AGE

Hypertension is an important risk factor of cardiovascular disease, especially stroke. However, there is controversy of how low blood pressure is beneficial. We followed up to old age a male cohort (n=3265), whose blood pressure was first measured 30-39 years earlier, during the 1960s. Baseline systolic blood pressure was divided into three categories: < 120 (n=204), 120-139 (n=1645), and >139 mm Hg (n=1416). Mortality up to year 2002 was derived from various registries, and health-related quality of life was assessed with RAND-36 (SF-36) in the year 2000. As compared to the middle category, a baseline blood pressure of >139 mm Hg was associated with 42% (p<0.0001) increased total mortality even though possible treatment during the long-term follow-up was not taken into account. An optimal blood pressure of < 120 mmHg did not significantly affect mortality (-4%, p=0.78) but was associated with a better quality of life (especially related to physical function) in old age. We conclude that these long-term results support current hypertension guidelines and that an optimal systolic blood pressure of < 120 mm Hg may have further benefits.