ABSTRACT
Dyslipidemia is an important risk factor of atherosclerotic cardiovascular disease (ASCVD). Statins delay the occurrence and development of ASCVD, and reduce the risk of cardiovascular events and death. Due to safety concerns, there exist insufficient use of lipid-lowering agents and a high withdrawal rate of the agents in the elderly. To promote the prevention and treatment of ASCVD, this expert consensus is issued and focuses on the management of dyslipidemia of Chinese elderly basing on the clinical evidence of the use of lipid-lowering drugs by the elderly, and the lipid management guidelines and expert consensus recommendations at home and abroad.
ABSTRACT
Objective:To investigate differences in the value of three chronic kidney disease epidemiology collaboration(CKD-EPI)estimation formulas in the evaluation of renal function damage in elderly patients with hypertension.Methods:A total of 58 patients with essential hypertension over 65 years of age were enrolled from November 2018 to March 2019 in this retrospective analysis.Patients with abnormal results in one or more items out of serum creatinine(Scr), blood urea nitrogen and urine protein were included in the hypertensive renal damage group(the positive group, n=25)and patients without abnormal results were included in the simple hypertensive group(the negative group, n=33). We measured Scr and cystatin c(Cys C)levels in fasting blood for each group.The estimated glomerular filtration rates(eGFR Scr, eGFR Cys C and eGFR Scr-Cys C)were calculated using the CKD-EPI formulas. Results:There was no statistically significant difference in gender, age, body mass index, grade of hypertension, onset time of hypertension, total cholesterol and triglycerides between the two groups( P> 0.05). There were significant differences in Cys C, eGFR Scr, eGFR Cys C and eGFR Scr-Cys C between the two groups( P<0.05). Spearman correlation analysis showed that Cys C was positively correlated with Scr( r=0.427, P<0.01), serum urate( r=0.266, P<0.05)and blood urea nitrogen( r=0.357, P<0.01)and was negatively correlated with eGFR Scr( r=-0.369, P<0.01), eGFR Cys C( r=-0.982, P<0.01)and eGFR Scr-Cys C( r=-0.845, P<0.01). Of the three formulas, eGFRScr-Cys C had the largest area under the receiver operating characteristic(ROC)curve(AUC)and its value was 0.707(0.565, 0.849). Conclusions:For the three estimation formulas, CKD-EPI Scr-Cys C has slightly better diagnostic efficiency than the others and may help improve the diagnosis of renal damage in elderly patients with hypertension.
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Objective:To investigate the correlation between lipoprotein(a)[Lp(a)]levels and parameters for left ventricular structure in elderly hypertensive patients.Methods:A total of 65 patients aged ≥65 years diagnosed with essential hypertension were enrolled in this retrospective analysis.Left atrial diameter dilation(LAD)was measured to evaluate the degree of cardiac involvement.According to the existence of LAD, patients were divided into the negative group(n=43)and the positive group(n=22). The differences in levels of blood lipids including Lp(a)and LAD as well as other echocardiographic indexes between the two groups were compared, and their correlations were analyzed.Results:Compared with the negative group, the duration of hypertension, LAD, and Lp(a)level increased in the positive group( P<0.05). LAD was correlated with age, duration of hypertension, left ventricular end diastolic diameter and Lp(a)level.The Lp(a)level was correlated with age and LAD( P<0.05). Logistic regression analysis showed that duration of hypertension( OR=1.060, 95% CI: 1.008-1.116)and Lp(a)level( OR=6.394, 95% CI: 1.038-39.396)were independent risk factors for LAD.The area under the receiver operating characteristic(ROC)curve of Lp(a)for LAD was 0.665(0.524, 0.806). Conclusions:Laboratory testing for serum lipoprotein(a) levels will help assess the degree of cardiac involvement in patients with hypertension and has practical value for the risk assessment of cardiac remodeling in elderly hypertensive patients.
ABSTRACT
A series of research achievements have been made in the cardiovascular disease prevention and treatment in 2009.Important trials in the fields of ischemic heart disease,hypertension,heart failure,lipid abnormality,and cardiac arrhythmia have been conducted,which casts new lights on management of cardiovascular diseases.Moreover,some guidelines have been updated and published by authorities based on the new research findings,providing new evidence for management of related diseases.
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Hypertension is a highly prevalent cardiovascular risk factor worldwide.Although the treatment of hypertension has been shown to prevent cardiovascular diseases and to extend and enhance life,hypertension remains inadequately managed,especially in developing country,such as China.Hypertension is one of the major causes of current global disease burden and is as prevalent in China as in the developed world.Blood pressure-induced cardiovascular risk rises continuously across the whole blood pressure range.During the past decades,much evidence has become available to support a systolic blood pressure threshold of 140 mmHg for even 'low-risk' patients,and,in high-risk patients there is evidence for lower thresholds.Lifestyle modification is recommended for all individuals and should be taken as the cornerstone of anti-hypertensive schedule.Monotherapy is inadequate for the majority of patients and more than two-thirds patients should receive combined anti-hypertension treatment,with fixed-dose combination being an ideal choice.The situation of blood pressure controlling could be improved if the government is involved in the anti-hypertension program.
ABSTRACT
Office blood pressure has been regarded as a gold standard of blood pressure measurements.It is an important indicator of ensurement of correct diagnosis,management of condition and evaluation of prognosis.But limitations of office blood pressure have led to the increasing use of out-of-office blood pressure.Many evidence show that out-of-office blood pressure could more accurately reflex variability of blood pressure and rhythm of blood pressure.Out-of-office blood pressure could diagnose white-coat hypertensives or masked hypertensives without delay,properly determine the need for antihypertensive treatment and decrease risk of developing blood pressure-related complications.