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Revisiting the association of blood pressure with mortality in oldest old people in China: community based, longitudinal prospective study

BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k2158 (Published 05 June 2018) Cite this as: BMJ 2018;361:k2158

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Managing blood pressure in older adults

Re: Revisiting the association of blood pressure with mortality in oldest old people in China: community based, longitudinal prospective study

Many thanks to Drs. Ben Freedman and Thomas Heston for their response to this paper. On behalf of all co-authors, I reply as follows.

As described in the main text:

"Before the inflection point of systolic blood pressure at 129 mm Hg, risk of all cause mortality fell with increasing systolic blood pressure (hazard ratio 1.47 (95% confidence interval 1.01 to 2.17) at 75 mm Hg, 1.41 (1.03 to 1.93) at 80 mm Hg, 1.29 (1.06 to 1.56) at 90 mm Hg, 1.16 (1.03 to 1.31) at 100 mm Hg, and 1.08 (1.01 to 1.17) at 106 mm Hg). After the inflection point, risk of all cause mortality rose with increasing systolic blood pressure (1.08 (1.01 to 1.17) at 155 mm Hg, 1.10 (1.01 to 1.20) at 160 mm Hg, 1.15 (1.03 to 1.29) at 170 mm Hg, 1.21 (1.03 to 1.45) at 180 mm Hg, and 1.27 (1.02 to 1.58) at 190 mm Hg; fig 2)."

This was summarised in the abstract: "Compared with a systolic blood pressure value of 129 mm Hg, risk of all cause mortality decreased for values lower than 107 mm Hg (from 1.47 (95% confidence interval 1.01 to 2.17) to 1.08 (1.01 to 1.17)), and increased for values greater than 154 mm Hg (from 1.08 (1.01 to 1.17) to 1.27 (1.02 to 1.58))."

Although we don't think it was a mistake, to make it more clear to The BMJ readers, we suggest revising the sentence in the abstract to:

"Compared with a systolic blood pressure value of 129 mm Hg, risk of all cause mortality decreased with increasing values when lower than 107 mm Hg (from 1.47 (95% confidence interval 1.01 to 2.17) to 1.08 (1.01 to 1.17)), and increased for values greater than 154 mm Hg (from 1.08 (1.01 to 1.17) to 1.27 (1.02 to 1.58))."

Competing interests: No competing interests

09 August 2018
Xiaoming SHI
Epidemiologiest and Public Health Expert
National Institute of Environmental Health, Chinese Center for Disease Control and Prevention
No.7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, P.R.C.