Blood pressure and disability in the elderly

Disability is a frequent outcome of many cardiovascular diseases, in particular stroke and heart failure, which occur more often with advancing age. Both of these conditions are potentially preventable through control of cardiovascular risk factors, especially of high blood pressure. In observational epidemiologic studies, high blood pressure was shown to be a potent risk factor for mortality, morbidity, and disability in the elderly, whereas intervention studies suggest that this risk can be reduced by appropriate treatment also at an advanced age. It is also conceivable that high blood pressure contributes to cognitive and functional impairment in the elderly, even in the absence of clinical events. As a possible mechanism, subclinical cerebral damage is hypothesized in these cases. This review examines findings of studies on epidemiology of disability, of disabling cardiovascular diseases, and of high blood pressure in the elderly. The available evidence on the relationship between high blood pressure and the development of disability will be focussed.