Cross-Sectional Centiles of Blood Pressure by Age and Sex: a four-hospital database retrospective observational analysis

David Wong, Stephen Gerry, Farah Shamout, David A Clifton, Marco Pimentel, Peter Watkinson

Research output: Contribution to journalArticlepeer-review

Abstract

objectives: National guidelines for identifying physiological deterioration and sepsis in hospitals depend on thresholds for blood pressure that do not account for age or sex. In populations outside hospital, differences in blood pressure are known to occur with both variables. Whether these differences remain in the hospitalised population is unknown. This database analysis study aims to generate representative centiles to quantify variations in blood pressure by age and sex in hospitalised patients. design: retrospective cross-sectional observational database analysis. setting: four near-sea-level hospitals between April 2015 and April 2017 participants: 75342 adult patients who were admitted to the hospitals and had at least one set of documented vital sign observations within 24 hours before discharge were eligible for inclusion. Patients were excluded if they died in hospital, had no vital signs 24 hours prior to discharge, were readmitted within 7 days of discharge, had missing age or sex or had no blood pressure recorded. results: Systolic blood pressure for hospitalised patients increases with age for both sexes. Median systolic blood pressure increases from 122 (CI: 121.1 – 122.1) mmHg to 132 (CI: 130.9 – 132.2) mmHg in men, and 114 (CI: 113.1-114.4) mmHg to 135 (CI: 134.5-136.2) mmHg for women, between the ages of 20 and 90. Diastolic blood pressure peaked around 50 years for men 76 (CI: 75.5-75.9) mmHg and women 69 (CI: 69.0-69.4) mmHg. The blood pressure criterion for sepsis, systolic < 100mmHg, was met by 2.3% of younger (20-30yrs) men and 3.5% of older men (81-90yrs). In comparison, the criterion was met by 9.7% of younger women and 2.6% of older women. Conclusion: We have quantified variations in blood pressure by age and sex in hospitalised patients that have implications for recognition of deterioration. Nearly 10% of younger women met the blood pressure criterion for sepsis at hospital discharge
Original languageEnglish
JournalBMJ Open
Volume10
Issue number5
DOIs
Publication statusPublished - 5 May 2020

Keywords

  • blood pressure
  • hospitals
  • ageing
  • physiology

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