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Systolic blood pressure (SBP) and resting pulse rate (RPR) have been linked to mortality and cardiovascular events in younger population. Till now, no studies simultaneously investigate the non‐linear association of SBP and RPR with all‐cause and cardiovascular mortality among population aged 80 and older. Data of 2828 eligible participants were selected from electronic health records linked attended automated office blood pressure measurement system. The dose‐response relationship between the SBP, RPR, and the risk of all‐cause and cardiovascular mortality was analyzed by Cox model with restricted cubic splines. During the 3.6‐year follow‐up, 442 deaths occurred. Comparing with the optimal SBP (117‐145 mmHg), the lower (HR: 1.39, 95% CI: 1.07‐1.81) and higher SBP (HR: 1.34, 95% CI: 1.08‐1.65) were significantly associated with an increasing risk of all‐cause mortality. The higher SBP (>144 mmHg) was associated with cardiovascular mortality, with the HR (95% CI) as 1.51 (1.07‐2.12). The faster RPR showed the higher risk of all‐cause (HR: 1.36, 95% CI: 1.05‐1.76) and cardiovascular (HR: 1.51, 95% CI: 1.07‐2.13) mortality. We found both higher SBP and faster RPR were independently associated with all‐cause and cardiovascular mortality, and lower SBP was only associated with the increased risk of all‐cause mortality in oldest old community‐dwelling Chinese population. Our results demonstrate the prognostic importance of both SBP and RPR in the elderly.

Background Blood pressure variability is a common physiological phenomenon; however, the association between within-visit and visit-to-visit variability in blood pressure and all-cause mortality remains uncertain. Methods We conducted a retrospective analysis of blood pressure variability among 11 721 adults who underwent blood pressure measurement on three occasions within a period of 6 months. Within-visit and visit-to-visit variability was quantified using the standard deviation and maximum--minimum difference between measures. The predictive effect of this variability on all-cause mortality was evaluated using Kaplan--Meier survival curves and Cox regression analysis. Results The incidence of all-cause mortality was significantly higher for participants in the top quintile of within-visit and visit-to-visit blood pressure variability and for those with sustained high within-visit variability. Within-visit variability was not retained as a risk factor after adjustment in Cox regression models. The hazard ratio for mortality increased from 48 to 55% for the top quintile of visit-to-visit blood pressure variability and from 56 to 61% for sustained high within-visit variability. The risk of mortality remained statistically higher even if visit-to-visit blood pressure variability was added to the model, including consistency of within-visit blood pressure variability and vice versa. Conclusion Visit-to-visit and sustained high within-visit blood pressure variability were significant positive prognostic factors for all-cause mortality. Our findings underlined the clinical significance of achieving stable blood pressure in an effective plan of hypertension management.