Objective

To study the impact of a history of hypertension and current blood pressure on mortality in the oldest old.

Design

An observational population-based cohort study.

Setting

Community city of Leiden, The Netherlands.

Participants

Five hundred and ninety-nine inhabitants of the birth-cohort 1912-1914 were enrolled on their 85th birthday. There were no selection criteria related to health or demographic characteristics.

Interventions

The mean follow-up was 4.2 years. Medical histories were obtained from general practitioners. Medication histories were obtained from the participant’s pharmacist. Blood pressure was measured twice at baseline.

Main outcome measures

All cause and cardiovascular mortality.

Results

Five hundred and seventy-one participants were included, 39.2% had a history of hypertension. During follow-up 290 participants died, 119 due to cardiovascular causes. Compared to participants without a history of hypertension, those with a history of hypertension had increased mortality from cardiovascular causes [relative risk (RR) 1.60, confidence interval (CI) 1.06-2.40] but equal mortality from all causes (RR 1.19, CI 0.91-1.55). High blood pressure at baseline (age 85) was not a risk factor for mortality. Baseline blood pressure values below 140/70 mmHg (n = 48) were associated with excess mortality, predominantly in participants with a history of hypertension.

Conclusion

In the oldest old, high blood pressure is not a risk factor for mortality, irrespective of a history of hypertension. Blood pressure values below 140/70 mmHg are associated with excess mortality.