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Objective To investigate the present situation on therapy and secondary prevention of coronary heart disease (CHD) in the elderly,and to improve treatment and secondary prevention.Methods Cross sectional,non-intervention and multicenter survey was used in this study.All 7962 effective interviewed cases were with aged ≥60 years from 116 hospitals of 21 provinces and cities during April and July of 2011.Among them,male was 63.4％,aged (73.0±7.9) years,24.1％cases were aged ≥80 years.The current treatment and risk factors of elderly CHD were investigated by questionnaire including basic information,health check,types and severe degree of CHD,its therapy and prevention,and control of the risk factors.Results (1) All cases were received drugs and percutaneous coronaryintervention (PCI) or surgery,27.5％ cases of PCI,2.6％ of coronary artery bypass grafting(CABG),70.4％ cases of expectant treatment.(2) The ratio of cases with angina pectoris and myocardial infarction was 76.5 ％,the attack of angina pectoris ≥3 times/weeks in recent month was 48.3％,Canadian Cardiovascular Society(CCS) Ⅱ scores and over was 79.3％.(3) The utility ratio of prevention drugs recommended by the guidelines were 70.3％ antiplatelet drug,54.9％ lipid regulating agents,47.5％ BB,29.0％/22.2％ ACEI/ARB.(4)The situation of risk factor control was as followed:among all the cases,38.9％ of them with active smoking≥1 counts/day,28.4％ of them with passive smoking,57.6％ of them with BMI ≥24,46.4％ of male with waistline ≥90 cm,41.1％ of female with waistline≥85 cm.In our cases,67.6％ of them with hypertension and 56.6％ achieved the level of blood pressure＜140/90 mm Hg; 23.4％ with diabetes mellitus and 49.5％ achieved the level of HbA1c ＜7.0％; 33.2％ with Lipids disorder and 26.6％ achieved the level of TC＜4.1 mmol/L,27.5％ of LDL-C＜2.6 mmol/L.(5) The analysis showed that there were more attacks of angina pectoris in the groups of male than female(P=0.0050),those HbA1c ≥7.0％ than those ＜7.0％ (P=0.019),and those LDL-C≥2.6 mmol/L than those ＜2.6 mmol/L (P =0.044),and that there were less attacks in those with CABG than without it (P＜0.001) and in those with PCI than without it (P＜0.001).Conclusions Inadequate control of symptom,insufficient utility ratio of prevention drugs and control of risk factors appear in elderly CHD.Coronary revascularization,drug use of guidelines recommend and control of high risks are the key points of high curative effect of elderly CHD.
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Objective To study the individualized dose of warfarin in treating atrial fibrillation in elderly patients. Methods Forty-one elderly in-patients with atrial fibrillation were recruited.Warfarin was used tO start anti-coagulation therapy with the target INR value 1.6-2.5.The data of demographic variables,concomitant diseases,medications and laboratory values were collected,then correlated these factors with the maintenance dose of warfarin. Results Warfarin dose requirements were significantly associated with age(r=-0.535,P＜0.01),sex(r=-0.494,P＜0.01),height (r=0.484,P＜0.01),weight(r=0.453,P＜0.01),body surface area(r=0.388,P＜0.05),concomitant use of a sulfonylurea medication(r=-0.446,P＜0.01)and serum albumin level(r=0.520,P＜0.01).The multivariate regression model includedthe variables of age,sex,serum albumin level and concomitant use of a sulfonylurea medication.This algorithm explained 65.4%of the variance in the maintenance dose of warfarin(R=0.808,R2=65.4%). Conclusions The warfarin dose in treating atrial fibrillation in elderly patients can be estimated from demographic,clinical and laboratory factors that can be obtained at the time of warfarin initiation.
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Objective To assess metabolic alterations in the human basal ganglia area during maturation and aging by using 2D chemical shift imaging (2D CSI) of proton magnetic resonance spectroscopy (1H-MRS). Methods Seventy healthy subjects were examined by 2D CSI. 2D CSI imaging acquisition was performed in the bilateral caudate, lentiform and thalamus. 1H-MRS was processed to determine the metabolite ratios, including NAA/Cho, NAA/Cr, Cho/Cr. Seventy healthy subjects were divided into 3 groups:20 to 39 years of age group, 40 to 59 years of age group and 60 to 87 years of age group. The three groups of healthy participants were compared. Results There was a significant decrease with aging in the NAA/Cho ratio in the bilateral lcntiform, thalamus and left caudate, and a significant decrease with aging in NAA/Cr ratio in the bilateral thalamus,right lentiform and left caudate (P<0.05), whereas the Cho/Cr ratio was significantly increased in the bilateral lentiform with aging(P<0.05). Conclusions The results of 1H-MRS show significant changes in the level of metabolites during the process of aging. This technique may play an important role in clinical studies and applications for various conditions of metabolic disorders of the human brain.
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Objective To investigate the characteristics of the heart rate variability(HRV) in the elderly bedridden patients. Methods 91 hospitalized patients (age≥60 years ) were divided into three groups according to the function independent measure: independent group (32 cases), partial dependent group (31 cases), dependent group(28 cases). Eight items of HRV were measured, including 24 hour standard deviation of successive normal-to-normal R-R interval(SDNN), total power (TP),standard deviation of all means of 5-minutes R-R interval all over 24 hour(SDANN), low frequency (LF), root mean squared successive difference(MSSD),Edingburgh Index(PNN50), high frequency(HF)and ratio of LF to HF(LF/HF). Results Seven items of HRV of the dependent group and partial dependent group were significantly lower than those of independent group (P0.05). SDNN and FIM were positively correlated (r =0.853, P=0.017). Other factors such as pathogen and the number of concomitant diseases did not affect on HRV in the elderly bedridden patients. Conclusions The HRV in the elderly bedridden patientsdecreased , the changes relatedthe decrease of the activity.
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Objective To evaluate mini-nutritional assessment (MNA), short-form ~mini-nutritional assessment ( MNA-SF) and classical nutritional assessment (CNA) in order to assess the nutritional status of aged people. Methods By MNA, MNA-SF and classical nutritional biochemistry markers, the nutritional status of 144 hospitalized elderly was investigated. Results (1) The nutritional status of 144 hospitalized aged people measured by MNA was that the prevalence of malnutrition and risk of malnutrition were 36.1% and 46.5% respectively. By using MNA-SF, the prevalence of malnutrition was 71.5%, and the prevalence of malnutrition ranged from 13.2% to 72.2% when we used classical method. (2) The correlation coefficients of MNA and CNA indexes of BMI, the circumferences of leg and upper arm, TSF, serum albumin, PAB, TG and Hb were 0.204~0.617 (P