Lower extremity muscular strength,sedentary behavior,and mortality

To examine whether lower extremity strength (LES) is predictive of all-cause mortality, independent of physical activity and among those with vary levels of sedentary behavior. Data from the 1999–2002 National Health and Nutrition Examination Survey was used (N = 2768; 50–85 years). Peak isokinetic knee extensor strength was objectively measured, sedentary behavior and physical activity were self-reported, and mortality was assessed via the National Death Index, with follow-up through 2011. Participants were followed for up to 12.6 years with the weighted average follow-up period lasting 9.9 years (standard error, 1.13). In the sample, 321,996 person-months occurred with a mortality rate of 2.1 deaths per 1000 person-months. After adjustments (including physical activity), for every 15 N increase in LES, participants had a 7 % reduced risk of all-cause mortality (HR = 0.93; 95 % CI 0.91–0.95; P < 0.001). When adding a three-level sedentary behavior variable (< 2, 2–4, 5+ h/day) as a covariate in this model, results were unchanged (HR = 0.93; 95 % CI 0.92–0.96; P < 0.001). Similarly, when sedentary behavior was included as a continuous covariate in the model, results regarding the relationship between LES and mortality were unchanged (HR = 0.94; 95 % CI 0.91–0.96; P < 0.001). There was no evidence of statistical interaction between LES and sedentary behavior on all-cause mortality (HR_interaction = 1.01; 95 % CI 0.92–1.10; P = 0.88). LES was inversely associated with all-cause mortality, and this association was unchanged when considering the participant’s sedentary behavior.     

Role of obesity on all-cause mortality in whites with type 2 diabetes from Italy

Mortality rate of diabetic patients is twice as much that of non-diabetic individuals. The role of obesity on mortality risk in patients with type 2 diabetes is controversial. Aim of our study was to address the relationship between obesity and all-cause mortality in a real-life set of white patients with type 2 diabetes from central-southern Italy from the Gargano Mortality Study (GMS). In addition, we used genetic data from genome-wide association studies (GWAs)-derived single nucleotide polymorphisms (SNPs) firmly associated with body mass index (BMI), in order to investigate the intrinsic nature of reduced mortality rate we, in fact, observed in obese patients. Study subjects with type 2 diabetes (n = 764) are part of the GMS, which is aimed at unraveling predictors of incident all-cause mortality. Time-to-death analyses were performed by Cox regression. Association between genotype risk score and obesity was tested by logistic regression. Of the 32 SNPs firmly associated with BMI, we investigated those with BMI β value ≥0.10 kg/m² and allele frequency ≥10 %. Genotyping was performed by KBioscience (http://www.lgcgenomics.com/). In GMS, obesity predicted a 45 % reduction in all-cause mortality. Individuals with high “obesity genetic load” (i.e., those carrying >9 risk alleles) were 60 % more likely to be obese as compared to individuals with low “obesity genetic load.” Most importantly, mortality rate was not different in individuals with high and low “obesity genetic load,” thus indicating no role of obesity genes on all-cause mortality and speaking against a cause–effect relationship underlying the association between obesity and reduced mortality rate.     

Nonlinear association of BMI with all-cause and cardiovascular mortality in type 2 diabetes mellitus: a systematic review and meta-analysis of 414,587 participants in prospective studies

Aims/hypothesis

The relationship between BMI and mortality has been extensively investigated in the general population; however, it is less clear in people with type 2 diabetes. We aimed to assess the association of BMI with all-cause and cardiovascular mortality in individuals with type 2 diabetes mellitus.

Methods

We searched electronic databases up to 1 March 2016 for prospective studies reporting associations for three or more BMI groups with all-cause and cardiovascular mortality in individuals with type 2 diabetes mellitus. Study-specific associations between BMI and the most-adjusted RR were estimated using restricted cubic splines and a generalised least squares method before pooling study estimates with a multivariate random-effects meta-analysis.

Results

We included 21 studies including 24 cohorts, 414,587 participants, 61,889 all-cause and 4470 cardiovascular incident deaths; follow-up ranged from 2.7 to 15.9 years. There was a strong nonlinear relationship between BMI and all-cause mortality in both men and women, with the lowest estimated risk from 31–35 kg/m² and 28–31 kg/m² (p value for nonlinearity <0.001) respectively. The risk of mortality at higher BMI values increased significantly only in women, whilst lower values were associated with higher mortality in both sexes. Limited data for cardiovascular mortality were available, with a possible inverse linear association with BMI (higher risk for BMI <27 kg/m²).

Conclusions/interpretation

In type 2 diabetes, BMI is nonlinearly associated with all-cause mortality with lowest risk in the overweight group in both men and women. Further research is needed to clarify the relationship with cardiovascular mortality and assess causality and sex differences.

     

Body mass index and mortality in people with and without diabetes: A UK Biobank study

Background and Aims

To investigate the association of body mass index with all-cause, cardiovascular and cancer mortality in individuals with and without diabetes.

Body mass index and mortality in patients with severe coronary artery diseases: A cohort study from China

Background and aimsIt is still controversial whether obesity and overweight increase the risk of mortality for patients with coronary artery disease. The current study aimed to investigate the relationship between body mass index (BMI) and mortality in patients with triple-vessel disease (TVD).Methods and resultsFrom April 2004 to February 2011, 8943 patients with angiographically confirmed TVD were consecutively enrolled. Patients were divided into five groups according to BMI: underweight (<18.5 kg/m²), normal weight (18.5–23.9 kg/m²), overweight: (24–27.9 kg/m²), mild obesity (28–31.9 kg/m²), and severe obesity (≥32 kg/m²). The primary end point was all-cause death. Subgroup analysis was performed for treatment strategies: revascularization and medical treatment alone. During a median follow-up of 7.5 years, lower risks of mortality were observed in patients with overweight (adjusted HR 0.85, 95% CI 0.75–0.97) and mild obesity (adjusted HR 0.83, 95% CI 0.69–1.00) compared to those with normal weight. Polynomial Cox regression suggested a U-shape association between BMI and adjusted mortality risk. In the revascularization subgroup, there was a significantly higher mortality risk in patients with severe obesity (adjusted HR 1.57, 95% CI 1.03–2.40) than in those with normal weight. While in the medical treatment subgroup, mortality risk decreased as BMI increased, with the lowest risk being observed in patients with severe obesity.ConclusionThere is a U-shape relationship between BMI and all-cause death in patients with TVD, with increased risks among both underweight and severely obese patients. This relationship may be influenced by treatment strategies.     

Effects of smoking in patients treated with cardiac resynchronization therapy

Smoking is associated with increased morbidity and mortality in cardiac patients. However, data on the prognostic impact of smoking in heart failure (HF) patients on cardiac resynchronization therapy with defibrillator (CRT-D) are absent. We investigated the effects of smoking on all-cause mortality and on a composite endpoint (all-cause death/appropriate device therapy), appropriate and inappropriate device therapy, in 649 patients with HF who underwent CRT-D between January 2003 and October 2011 in 6 Centers (4 in Italy and 2 in USA). 68 patients were current smokers, 396 previous-smokers (patients who had smoked in the past but who had quit before the CRT-D implant), and 185 had never smoked. The risk of each endpoint by smoking status was evaluated with both Kaplan–Meier and Cox proportional-hazard analysis. After adjusting for age, left ventricular ejection fraction, QRS width and ischemic etiology, both current and previous smoking were independent predictors of all-cause death [HR = 5.07 (95 % CI 2.68–9.58), p < 0.001 and HR = 2.43 (95 % CI 1.38–4.29), p = 0.002, respectively) and of composite endpoint [HR = 1.63 (1.04–2.56); p = 0.033 and HR = 1.46 (1.04–2.04) p = 0.027]. In addition, current smokers had a significantly higher rate of inappropriate device therapy compared to never smokers [HR = 21.74 (4.53–104.25), p = 0.005]. Our study indicates that in patients with HF who received a CRT-D device, current and previous smoking increase the event rate per person-time of death and of appropriate and inappropriate ICD therapy more than other known negative prognostic factors such as age, left ventricular dysfunction, prolonged QRS duration and ischemic etiology.     

Inflammatory plasma markers and risk for venous thromboembolism

Venous thromboembolism (VTE) and arterial thrombosis have been thought to result from two different mechanisms. Recent data indicate that the two diseases may share some common risk factors, such as the activity of inflammation on haemostasis. In this population-based study we explored whether raised levels of inflammation-sensitive plasma markers (ISPs) increase the risk for venous thromboembolism. Measurements of five ISPs (fibrinogen, haptoglobin, ceruloplasmin, α1-antitrypsin and orosomucoid) were performed in 6,068 subjects from “the Malmö Preventive Study”. These apparently healthy men from the city of Malmö in Sweden, were included in the study between 1974 and 1982 and followed up until 2008. We calculated the hazard ratio (HR) for VTE in relation to the number of raised ISPs as well as individual ISPs in the fourth quartile. Mean follow-up time was 26.2 years. Out of the cohort (n = 6,068), 398 (6.6 %) had a venous thromboembolism during the follow-up. The number of raised ISPs was significantly associated with age, BMI and smoking. Age, BMI and diabetes mellitus type 2 were also significant risk factors for developing a VTE (HR = 1.05 with p < 0.01 and 95 % CI 1.01–1.08, HR = 1.10 with p < 0.001 and 95 % CI 1.06–1.14 and HR = 1.78 with p < 0.05 and 95 % CI 1.13–2.81, respectively). Incidence of venous thromboembolism was not significantly related to number of raised inflammatory proteins (p for trend = 0.37) or any of the individual ISPs. Age and BMI is significantly associated with the risk for developing VTE. Incidence of VTE was not associated with any of the inflammatory proteins.     

Body mass index is associated with prognosis in Japanese elderly patients with atrial fibrillation: an observational study from the outpatient clinic

The relationship between body mass index (BMI) and the prognosis of elderly patients with atrial fibrillation (AF) is unknown. We aimed to examine the association of body weight with the clinical outcomes among Japanese elderly patients with a history of documented AF. This observational study of AF patients from an outpatients clinic in Nagoya University Hospital included 413 patients ≥70 years old (99 obese: BMI ≥25 kg/m²; 256 normal weight: BMI 18.5–24.9 kg/m²; and 58 underweight patients: BMI <18.5 kg/m²). The mean age was 77.5 ± 5.6 years. During a mean follow-up of 19.0 months, all-cause death occurred in 23 patients (obese 1 %, normal weight 5.1 %, and underweight 16 %). The major adverse events including all-cause death, stroke or transient ischemic attack, heart failure requiring admission, and acute coronary syndrome were observed in 53 patients (obese 5.1 %, normal weight 13 %, and underweight 26 %). After adjusting for confounding factors, the underweight group had a significantly greater risk for all-cause death [hazard ratio (HR) 2.91, 95 % confidence interval (CI) 1.12–7.60, p = 0.029], and major adverse events (HR 2.45, 95 % CI 1.25–4.78, p = 0.009) than the normal weight group. In contrast, the obese group had a better prognosis in major adverse events compared with the normal weight group (HR 0.34, 95 % CI 0.13–0.89, p = 0.029). In conclusion, lower BMI was independently associated with poor outcomes among older AF patients. The association between obesity and better prognosis in elderly AF patients was also found.     

A Body Shape Index is positively associated with all-cause and cardiovascular disease mortality in the Chinese population with normal weight: A prospective cohort study

Background and aimA body shape index (ABSI) is a valuable predictor of mortality in the Western population, but similar evidence in the general Chinese population is limited. This study aims to evaluate the association between the ABSI and all-cause and cardiovascular disease (CVD) mortality in the Chinese population with normal weight.Methods and results9046 participants with normal BMI (18.5–24.9 kg/m²) from the China Hypertension Survey were enrolled. The baseline ABSI was calculated as waist circumference/(BMI^2/3height^1/2). Cox proportional hazards regression was performed to evaluate the association of the ABSI with all-cause and CVD mortality. Over an average follow-up of 5.4 years, 686 all-cause and 215 CVD deaths occurred. A 0.01-unit increment in the ABSI was associated with a 31% greater risk of all-cause mortality (hazard ratio [HR], 1.31; 95% CI: 1.12, 1.48) and CVD mortality (HR, 1.30; 95% CI: 1.08, 1.58). Compared with quartile 1 of the ABSI, the adjusted HRs of all-cause mortality for quartiles 2–4 were, respectively, 1.25 (95% CI: 0.98, 1.59), 1.28 (95% CI: 0.99, 1.67), and 1.54 (95% CI: 1.17, 2.03) (P_trend = 0.004), and those of CVD mortality for quartiles 2–4 were, respectively, 1.28 (95% CI: 0.88, 1.83), 1.42 (95% CI: 0.97, 2.08), and 1.45 (95% CI: 0.98, 2.170) (P_trend = 0.043). The dose–response analysis showed a linear positive association of the ABSI with all-cause (P_nonlinearity = 0.158) and CVD mortality (P_nonlinearity = 0.213).ConclusionThe ABSI was positively associated with all-cause and CVD mortality among the general Chinese population with normal BMI. The data suggest that the ABSI may be an effective tool for central fatness for mortality risk assessment.     

Sustained Physical Activity,Not Weight Loss,Associated With Improved Survival in Coronary Heart Disease

Background

Individuals with coronary heart disease (CHD) are recommended to be physically active and to maintain a healthy weight. There is a lack of data on how long-term changes in body mass index (BMI) and physical activity (PA) relate to mortality in this population.

Dairy shows different associations with abdominal and BMI-defined overweight: Cross-sectional analyses exploring a variety of dairy products

Background and aims

Previous studies have suggested weight–regulatory properties for several dairy nutrients, but population-based studies on dairy and body weight are inconclusive. We explored cross–sectional associations between dairy consumption and indicators of overweight.

Interaction of Physical Activity and Body Mass Index on Mortality in Coronary Heart Disease: Data from the Nord-Trøndelag Health Study

Objective

The role of physical activity in the relationship between body mass index (BMI) and survival in coronary heart disease is unclear. Our aim was to examine the isolated and combined associations among BMI, physical activity, and mortality in subjects with coronary heart disease.

Differential associations between body mass index and outcome in different age groups in patients with myocardial infarction

ObjectiveTo investigate the association between age and body mass index (BMI) and mortality in patients with myocardial infarction (MI). Methods We divided 6453 patients into three age groups (<60, 60–75, >75 years) and five BMI categories. Thirty-day and long-term all-cause mortality were assessed.ResultsNo association was found between the BMI category and 30-day mortality in any age group. The association between BMI and long-term multivariable-adjusted mortality risk was age-dependent. Overweight patients had a lower risk than patients with BMI <25 kg/m² in all age groups (HR 0.62; 95%CI 0.45–0.85; p = 0.003, HR 0.78; 95%CI 0.65–0.93; p = 0.005, HR 0.82; 95%CI 0.70–0.95; p = 0.011 for ages <60, 60–75, >75 years, respectively). The lower risk of death as a function of BMI shifted upward with age, and the risk was also lower in patients with obesity grade I (HR 0.81; 95% CI 0.66–0.98; p = 0.035 and HR 0.78; 95% CI 0.63–0.97; p = 0.023 for ages 60–75, >75 years, respectively). Excessive obesity was harmful only in the oldest group. Patients with obesity grade III had more than a 2.5 times higher mortality risk than patients with BMI <25 kg/m² only in this group (HR 2.58; 95%CI 1.27–5.24; p = 0.009). An obesity paradox was found in all age groups.ConclusionOur results suggest that moderate weight gain with age improves long-term survival after MI and that the magnitude of this “protective” weight gain is greater in older compared to younger patients. However, excessive weight gain (obesity grade III) is particularly harmful in the oldest age group. The exact relationship between BMI, age, and mortality remains unclear.     

Association of single measurement of estimated glomerular filtration rate and non-quantitative dipstick proteinuria with all-cause and cardiovascular mortality in the elderly. Results from the Progetto Veneto Anziani (Pro.V.A.) Study

ObjectiveTo explore the independent and combined clinical validity of estimated glomerular filtration rate (eGFR) and proteinuria on predicting all-cause and cardiovascular mortality in an Italian elderly population.MethodsBaseline eGFR and proteinuria, all-cause and cardiovascular mortality during a mean follow-up time of 4.4 years were evaluated in 3063 subjects aged 65 years and older of the Progetto Veneto Anziani (Pro.V.A.) Study.ResultsSubjects with eGFR < 60 ml/min/1.73 m² (n = 956) presented a higher prevalence of proteinuria in comparison with those with eGFR ≥ 60 ml/min/1.73 m² (33.8% vs 25.1%, p < 0.01). After multivariable adjustment including proteinuria and major diseases, eGFR < 60 ml/min/1.73 m² was not associated with increased all-cause mortality. After multivariable adjustment including eGFR and major diseases, proteinuria was associated with all-cause mortality in overall subjects (HR = 1.43, 95% CI 1.15–1.78, p < 0.01), and in both sexes. After multivariable adjustment both eGFR < 60 ml/min/1.73 m² (HR = 1.68, 95% CI 1.02–2.78, p = 0.04), and proteinuria (HR = 2.07, 95% CI 1.31–3.27, p < 0.01) were associated with increased cardiovascular mortality. Subjects with both impaired eGFR and presence of proteinuria showed a higher risk for both all-cause and cardiovascular mortality compared to those with normal eGFR and absence of proteinuria.ConclusionIn this general Italian elderly population proteinuria is an independent predictor of all-cause and cardiovascular mortality, while eGFR is not an independent predictor of all-cause mortality, and it is nominally significantly associated with cardiovascular mortality. However, mortality risk is higher in individuals with combined reduced eGFR and proteinuria.     

Association between body mass index and mortality in atrial fibrillation patients with and without diabetes mellitus: Insights from a multicenter registry study in China

Background and aimsThe aim of this study was to evaluate the association between body mass index (BMI) and mortality in atrial fibrillation (AF) patients with and without diabetes mellitus (DM).Methods and resultsA total of 1991 AF patients were enrolled and divided into two groups according to whether they have DM at recruitment. Baseline information was collected and a mean follow-up of 1 year was carried out. The primary outcome was defined as all-cause mortality with the secondary outcomes including cardiovascular mortality, stroke and major adverse events (MAEs). Univariable and multivariable Cox regression were performed to estimate the association between BMI and 1-year outcomes in AF patients with and without DM. 309 patients with AF (15.5%) had comorbid DM at baseline. Patients with DM were more likely to have cardiovascular comorbidities, receive relevant medications but carry worse 1-year outcomes. Multivariable Cox regressions indicated that elevated BMI was related with reduced risk of all-cause mortality, cardiovascular mortality and major adverse events. Compared to normal weight, overweight [HR (95% CI): 0.548 (0.405–0.741), p < 0.001] and obesity [HR (95% CI): 0.541 (0.326–0.898), p = 0.018] were significantly related with decreased all-cause mortality for the entire cohort. Remarkably reduced all-cause mortality in the overweight [HR (95% CI): 0.497 (0.347–0.711), p < 0.001] and obesity groups [HR (95% CI): 0.405 (0.205–0.800), p = 0.009] could also be detected in AF patients without DM, but not in those with DM.ConclusionElevated BMI was associated with reduced mortality in patients with AF. This association was modified by DM. The obesity paradox confined to AF patients without DM, but could not be generalized to those with DM.     

Fitness, fatness and survival in elderly populations

This study examines the relative importance of fitness versus fatness in predicting mortality in elderly populations aged 70 years and over, and whether fitness may account for the ‘paradoxical’ relationship between better survival and increasing weight. Four thousand community-living Chinese men and women aged 65 years or over were recruited and stratified so that approximately 33% were in each of the age groups: 65–69, 70–74, and 75 or above. Medical history, height, weight, waist–hip ratio, body composition using DEXA, and walking speed were obtained. They were followed up for a mean of 7.0 years to ascertain death. Compared with the high fitness category, those in the moderate and low categories have a 43% and 68% increased risk of mortality at 7 years adjusting for multiple confounders. When mortality risk according to various fatness indicators was examined, only the lowest quartile of BMI, BFI, and FLMR conferred statistically significant increased risk. Fitness categories were significantly associated with all fatness indicators. The finding of fewer people in the high fitness category among the highest quartiles of other fatness indicators suggests that fitness is not the underlying mechanism for the obesity paradox. Within each quartile of fatness indicator, there was a significant trend towards reduced mortality with increasing fitness. In conclusion, the study confirms the beneficial effects of cardiorespiratory fitness on mortality but does not explain the ‘obesity paradox’. The findings underscore the importance of maintaining physical fitness through exercise and re-confirm the importance of weight maintenance in reducing mortality risk.     

A Hazard Analysis of Risk Factors of Mortality in Individuals Who Inject Drugs in Denver CO

Despite multiple risk factors for mortality among People Who Inject Drugs (PWID), more research is warranted that examines sub-populations within PWID. Mortality data from PWID participating in longitudinal HIV prevention research in Denver were obtained from The Colorado Department of Public Health and Environment. Risk factors for both all-cause and acute-toxicity related mortality were analyzed using Cox proportional hazards regression. Two-thousand seven individuals were interviewed at baseline. Eighty-six individuals died during the time frame of the study, 58 of which were due to acute-toxicity. Disabled (HR = 3.3, p < 0.001), gay/lesbian-identified (HR = 2.6, p = 0.03), white race/ethnicity (HR = 2.4, p = 0.003), and use of a shared cooker (HR = 2.1, p = 0.01) were important adjusted risk factors. These suggest that drug and HIV interventions should utilize techniques that can address the needs of marginalized populations in addition to HIV drug risk behaviors.     

General and Abdominal Adiposity and Risk of Death in HBV Versus Non-HBV Carriers: A 10-Year Population-based Cohort Study

Both obesity and hepatitis B virus (HBV) infection increase the risk of death. We investigate the association between general and central obesity and all-cause mortality among adult Taiwanese HBV versus non-HBV carriers.A total of 19,850 HBV carriers and non-hepatitis C virus (HCV) carriers, aged 20 years and older at enrollment in 1998 to 1999 in Taiwan, were matched to 79,400 non-HBV and non-HCV carriers (1:4). Cox proportional-hazards models were used to estimate the relative risks for all-cause mortality during a maximum follow-up period of 10 years. Four obesity-related anthropometric indices—body mass index (BMI), waist circumference, waist-to-hip ratio, and waist-to-height ratio—were the main variables of interest.During the follow-up period, 628 and 2366 participants died among HBV and non-HBV carriers, respectively. Both underweight and general obesity were associated with an increased risk of death. The highest risk of all-cause death in relation to BMI was found in the HBV carriers with underweight (BMI <18.5 kg/m²) and non-HBV carriers with obesity (BMI ≥30 kg/m²). The lowest risks of all-cause death in relation to abdominal adiposity were found at the third quartiles of waist circumference, waist-to-hip ratio, and waist-to-height ratio among HBV carriers, but in the second quartiles among non-HBV carriers. For those with pre-existing liver disease among HBV carriers, patients with underweight have higher risk of death than those with obesity.Hepatitis B virus carriers with underweight have higher risk of death than non-HBV carriers. HBV carriers with mild abdominal obesity have the lowest risk of death, but not in the non-HBV carriers.     

Estimated glomerular filtration rate,albuminuria and mortality in type 2 diabetes: the Casale Monferrato study

Aims/hypothesis Estimated glomerular filtration rate (eGFR) predicts mortality in non-diabetic populations, but its role in people with type 2 diabetes is unknown. We assessed to what extent a reduction in eGFR in people with type 2 diabetes predicts 11-year all-cause and cardiovascular mortality, independently of AER and other cardiovascular risk factors. Materials and methods The study population was the population-based cohort (n = 1,538; median age 68.9 years) of the Casale Monferrato Study. GFR was estimated by the abbreviated Modification of Diet in Renal Disease Study equation. Results At baseline, the prevalence of chronic kidney disease (eGFR <60 ml min⁻¹ 1.73 m⁻²) was 34.3% (95% CI 33.0–36.8). There were 670 deaths in 10,708 person-years of observation. Hazard ratios of 1.23 (95% CI 1.03–1.47) for all-cause mortality and 1.18 (95% CI 0.92–1.52) for cardiovascular mortality were observed after adjusting for cardiovascular risk factors and AER. When five levels of eGFR were analysed we found that most risk was conferred by eGFR 15–29 ml min⁻¹ 1.73 m⁻², whereas no increased risk was evident in people with eGFR values between 30 and 59 ml min⁻¹ 1.73 m⁻². In an analysis stratified by AER categories, a significant increasing trend in risk with decreasing eGFR was evident only in people with macroalbuminuria. Conclusions/interpretation Our study suggests that in type 2 diabetes macroalbuminuria is the main predictor of mortality, independently of both eGFR and cardiovascular risk factors, whereas eGFR provides no further information in normoalbuminuric people.     

Low blood pressure levels for fall injuries in older adults: the Health,Aging and Body Composition Study

Fall injuries cause morbidity and mortality in older adults. We assessed if low blood pressure (BP) is associated with fall injuries, including sensitivity analyses stratified by antihypertensive medications, in community-dwelling adults from the Health, Aging and Body Composition Study (N = 1819; age 76.6 ± 2.9 years; 53% women; 37% black). Incident fall injuries (N = 570 in 3.8 ± 2.4 years) were the first Medicare claims event from clinic visit (7/00–6/01) to 12/31/08 with an ICD-9 fall code and non-fracture injury code, or fracture code with/without a fall code. Participants without fall injuries (N = 1249) were censored over 6.9 ± 2.1 years. Cox regression models for fall injuries with clinically relevant systolic BP (SBP; ≤ 120, ≤ 130, ≤ 140, > 150 mmHg) and diastolic BP (DBP; ≤ 60, ≤ 70, ≤ 80, > 90 mmHg) were adjusted for demographics, body mass index, lifestyle factors, comorbidity, and number and type of medications. Participants with versus without fall injuries had lower DBP (70.5 ± 11.2 vs. 71.8 ± 10.7 mmHg) and used more medications (3.8 ± 2.9 vs. 3.3 ± 2.7); all P < 0.01. In adjusted Cox regression, fall injury risk was increased for DBP ≤ 60 mmHg (HR = 1.25; 95% CI 1.02–1.53) and borderline for DBP ≤ 70 mmHg (HR = 1.16; 95% CI 0.98–1.37), but was attenuated by adjustment for number of medications (HR = 1.22; 95% CI 0.99–1.49 and HR = 1.12; 95% CI 0.95–1.32, respectively). Stratifying by antihypertensive medication, DBP ≤ 60 mmHg increased fall injury risk only among those without use (HR = 1.39; 95% CI 1.02–1.90). SBP was not associated with fall injury risk. Number of medications or underlying poor health may account for associations of low DBP and fall injuries.