Blood pressure distribution according to age in a study population of 35,869 participants aging 18 to 99 years

Objective: Only few studies examined in detail the distribution of blood pressure in populations according to age, sex and cardiovascular risk factors. Here we analyzed blood pressure data from a nation-wide cross-sectional study in Germany with 35,869 participants aging 18–99 years. Methods: Percentiles (pctl, 5th, 25th, 50th, 75th, 95th) for systolic blood pressure (SBP),and prevalence of hypertension according to JNC-7 were computed stratified by 5 year age-groups, sex and CVD risk factors (abnormal waist, high triglycerides, low HDL, diabetes, history of CVD, antihypertensive treatment). Results: According to the guidelines of JNC-7 half of all men and half of all women above 30 years of age had to be classified at least as pre-hypertensive. With the exception of the 5th pctl in all pctl-categories a constant age-related shift of 20mmHg was observed in men (5th pct: increase of 10mmHg). We found a similar pattern in women with the exception of the 95th pctl where a shift of >35mmHg was noticed, reaching an SBP >170mmHg at the age of 55+. In subjects without CVD, intake of antihypertensives and/or CVD risk factors this SBP shift was still present, i.e. men in the 5th pctl showed a maximum increase of 20mmHg reaching 120mmHg by the age of 85. However, in this group without CVD risk factor and intake of antihypertensives from the age of >70 years still 50% of men had to be classified as hypertensive according to JNC-7 guidelines. Conclusion: In our sample we observed a constant SBP shift by age even in subjects without CVD risk factors. If this observation is an effect of age or a birth cohort effect will be studied further using longitudinal data from a population-based prospective cohort study.