Locomotive syndrome is associated with large blood pressure variability in elderly hypertensives: the Japan Ambulatory Blood Pressure Prospective (JAMP) substudy

Under pressure: A systematic review of the association between blood pressure variability with depression and anxiety

Blood pressure variability (BPV) impacts brain health by influencing brain structure and cerebrovascular pathologies, though the mechanisms are poorly understood. Changes in the cerebrovasculature may lead to late-onset depression, cognitive impairment, and dementia, however the relationship between BPV with depression and anxiety remains unclear, due to methodological differences and inconsistencies in past research. This review aims to clarify the association between BPV with depression and anxiety in adults to inform understandings of the mechanisms implicating BPV in cognitive health. A systematic search from inception through to January 2024 was performed on Embase, PubMed, PsycINFO, and Web of Science. Studies that assessed BPV quantified by beat-to-beat, 24-hour, or visit-to-visit were eligible if the standardised assessment of depression and/or anxiety were reported as a linear association, or mean differences across control and affect groups. A total of 14 articles reporting on 13 samples and N = 5055 persons met the inclusion criteria (median female proportion = 61 %, range 0 % - 76 %). A meta-analysis was not possible due to methodological heterogeneity in BPV measurements and metrics across studies. Mixed results were observed across depression studies with inconsistencies and variation in the direction, strength of association, and BPV metric. There was weak evidence from only three studies to support a linear association between systolic coefficient of variation and anxiety. Collectively, the findings contribute to understanding the association between BPV and brain health, suggesting that any relationship between BPV and brain structures critical for cognitive function are independent of depression and only modestly implicate anxiety.

PREVALENCE AND FACTORS ASSOCIATED WITH LOCOMOTIVE SYNDROME IN COMMUNITY-DWELLING OLDER ADULTS

ABSTRACT Objective: to analyze prevalence and the factors associated with locomotive syndrome in community-dwelling older adults. Method: a cross-sectional study, developed in a municipal center for the care of older adults in Teresina, Piauí, Brazil. The sample was for convenience and comprised 204 older adults aged 60 years or more, of both genders and with preserved cognitive capacity, according to parameters of the Mini Mental State Examination. Data collection occurred from March to November 2018, by applying a form for sociodemographic, clinical and falls occurrence characterization and the 25-item Geriatric Locomotive Function Scale. To measure the strength of the associations between the variables, odds ratios and 95% confidence intervals were adopted. The statistical significance level was set at 5% for the analyses. Results: the prevalence of locomotive syndrome found was 37.2%. The factors associated with the presence of locomotive syndrome were individual monthly income (p=0.005); existence of one of the following comorbidities: systemic arterial hypertension (p=0.039), osteoporosis (p=0.016), arthrosis (p<0.001) or obesity (p=0.014); and history of hospitalization in the last year (p=0.007). Conclusion: the prevalence of locomotive syndrome found in this study was low and presented higher levels in older adults, with an individual monthly income of two to three minimum wages; who reported having hypertension, osteoporosis, arthrosis or obesity; and with a history of hospitalization in the last year. The health condition investigated showed to be related to aging, with significant repercussions on functionality.

Lifestyle-related signs of locomotive syndrome in the general Japanese population: A cross-sectional study

BACKGROUND

This study aimed to estimate the prevalence of locomotive syndrome (LS) risk in age groups using the LS risk test proposed by the Japanese Orthopaedic Association. Based on this, this study identified the lifestyle-related signs that lead to LS, by clarifying the association between LS risk and lifestyle factors.

METHODS

A total of 728 individuals aged 20-91 years who were without specific mobility disorders were evaluated. Participants were asked to perform the LS risk test and complete a self-administered original questionnaire survey for this study. The Mann-Whitney U test was used to examine the relationships of sex and age with LS. The prevalence of LS by sex and age was compared using the Chi-squared test or Student's t-test, as appropriate. The Mantel-Haenszel test was used to examine the relationship of each component of the lifestyle factors.

RESULTS

Overall, 36.4% of males and 49.1% of females were classified into the LS group; the prevalence of LS was significantly higher in females than males (p < .001). The prevalence of LS tended to increase with age in both males and females (p < .05). As for health condition, pain in the locomotive organs, knees, back, and hip joints was significantly associated with LS (p < .05). Of the lifestyle-related diseases, only hypertension (p < .05) was significantly associated with LS, and drug treatment was significantly associated with LS (p < .05). As for lifestyle, anxiety about physical fitness, self-assessed poor health, irregular dietary habits, and lack of exercise were also associated with LS (p < .05).

CONCLUSIONS

Interventions to prevent LS are important during its early stages, especially for females, and lifestyle-related signs of LS, such as pain in the locomotive organs, lifestyle-related disease, drug treatment, and a lower subjective evaluation of health must not be overlooked.

Impact of in-hospital blood pressure variability on cardiovascular outcomes in patients with acute coronary syndrome

To evaluate the impact of blood pressure variability (BPV) on cardiovascular outcomes in patients with acute coronary syndrome, short-term BPV was estimated by using weighted standard deviation of 24-hour ambulatory blood pressure monitoring readings. The primary outcome was in-hospital major adverse cardiac events (MACE). Overall, 200 patients (mean age, 58.6 years; 27.5% women; 38% with diabetes mellitus; and 47% smokers) were divided into low and high BPV groups based on the median value (9.45). Patients in the high BPV group were more likely to have in-hospital MACE compared with patients with low BPV (47% vs 27%, P = .003). Multivariate binary logistic regression analysis of incidence of MACE showed that BPV (odds ratio, 2.4; confidence interval, 1.2-4.5 [P = .008]) and presence of type II diabetes mellitus (odds ratio, 2.6; confidence interval, 1.2-5.3 [P = .008]) were the only independent predictors of in-hospital MACE derived mainly by hypertensive emergencies. BPV could be an important risk factor for in-hospital MACE in patients with acute coronary syndrome.