Hypertension and lower walking speed in the elderly: the Three-City study.

OBJECTIVE The brain is one of the main targets of hypertension. However, little is known about the relation between hypertension and motor performances. We studied the association between hypertension and walking speed in a cohort of elderly people. METHODS Analyses are based on participants (65-85 years) from the Dijon (France) center of the Three-City study (n = 3604), followed every 2 years. Persistent hypertension was defined by the use of antihypertensive drugs at baseline or at first follow-up, or by high blood pressure (> or =140/90 mmHg) at baseline and first follow-up. Walking speed was measured over 6 m, at baseline and fourth follow-up (n = 1774) after a mean (SD) duration of 7.0 (0.5) years. Brain MRI was performed in 1590 participants. Generalized linear models were used to assess the relation between hypertension and baseline walking speed or walking speed change. RESULTS At baseline, mean (SD) walking speed (m/s) was lower in hypertensive patients [1.51 (0.31)] than in nonhypertensive individuals [1.59 (0.30), P < 0.001]. During follow-up, hypertensive patients had a higher mean annual decline in walking speed [cm/s per year; 2.30 (3.4)] than nonhypertensive individuals [1.87 (3.3), P = 0.004]. The number of antihypertensive drugs was associated with lower walking speed at baseline and higher walking speed decline. Adjustment for MRI white matter abnormalities attenuated these relations. CONCLUSION Persistent hypertension was associated with both lower walking speed and higher decline in walking speed in the elderly. These results may be partly explained by white matter abnormalities and support the hypothesis of a contribution of vascular risk factors to motor dysfunction.