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Objectives: To investigate the status of secondary prevention, treatment and risk factors of retired elderly patients (≥80 years old) with coronary heart disease in Guangzhou. Methods: A total of 752 questionnaires were collected from the elderly patients with coronary heart disease who underwent routine cardiovascular checkup in our hospital from March to May in 2016. The questionnaire included basic situation, complications, weight, blood pressure, low density lipoprotein, glucose level and secondary prevention medications based on evidence-based medicine. Results: Antiplatelet drugs, beta blockers, statins, ACEI/ARB use rate was 55.72%, 30.98%, 25.13%, 42.69% for the secondary prevention; 21.94% patients did not take secondary prevention drugs, the combined use rate of the four drugs was 4.92%. In elderly patients with coronary heart disease, the control rate of blood pressure (<150/90 mmHg), fasting blood glucose (<7mmol/L), 2-hour postprandial blood glucose (<10 mmol/L), body mass index (<24 kg/m2) were 81.17% (470/579 cases), 77.61% (253/326 cases), 55.21% (180/326 cases) and 54.73% (266/486 cases), respectively. With LDL-C<1.8 mmol/L as the standard, percent with normal LDL-C value was 14.06% (63/448 cases). Conclusions: In this survey population, use rate of the four types of drugs for secondary prevention and the control rate of known risk factors for coronary artery disease are very low. Efforts are needed to improve rational use of the secondary prevention drugs, minimize the gaps between promote the guidelines and clinical practice, and reduce the recurrence rate of coronary heart disease in elderly patients with coronary artery disease.
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the impact of attack frequency as well as therapy strategies on outcome of patients with vasovagal syncope (VVS).</p><p><b>METHODS</b>A total of 159 patients (aged from 15 - 59 years old) with VVS were included in this study. Patients were divided into low frequency (< 3) group (n = 95) and high (≥ 3) frequency group (n = 64) according to the attack frequency in the past 5 years at the primary survey. Patients received one of the three therapies: no treatment, physical therapy, and comprehensive treatment. All cases were followed up with telephone or outpatient visit for 24 months.</p><p><b>RESULTS</b>Incidence of syncope was significantly higher in the high frequency group and in the low frequency group [40.6% (26/64) vs. 11.6% (11/95), P < 0.01]. The overall improvement rate was significantly higher in the low frequency group than that of high frequency group (P < 0.01). Improvement rate was significantly higher in the physical therapy subgroup and the comprehensive treatment subgroup than no treatment subgroup for patients with low attack frequency [81.8% (27/33) vs. 47.1% (8/17), P < 0.05; 82.2% (37/45) vs. 47.1% (8/17), P < 0.05], and in comprehensive treatment subgroup than in physical therapy subgroups observed between and [62.2% (28/45) vs. 31.6% (6/19), P < 0.05] for patients with high attack frequency.</p><p><b>CONCLUSION</b>Outcome is related to previous attack frequency for patients with VVS, physical therapy is effective for reducing the recurrence rate of syncope in VVS patients with low attack frequency while physical therapy combined with pharmacotherapy should be applied for VVS patients with high attack frequency to improve outcome.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Physical Therapy Modalities , Prognosis , Syncope, Vasovagal , Diagnosis , Therapeutics , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To determine the prevalence and clinical characteristics of orthostatic hypotension (OH) in the elderly and retired population.</p><p><b>METHODS</b>A total of 1174 elderly and retired people underwent health screening physical examination in Guangzhou military region were included. The orthostatic blood pressure and heart rate were measured in supine position after resting for more than 5 minutes and at 0 and 2 min after standing. Subjects were divided into OH positive group and OH negative group. Orthostatic hypotension was defined as 20 mm Hg (1 mm Hg = 0.133 kPa) or greater decrease in SBP and/or 10 mm Hg or greater decrease in DBP after standing.</p><p><b>RESULTS</b>The prevalence of OH in this cohort was 25.6% at either 0 or 2 min after standing (21.6% or 20.7% respectively). Incidence of hypertension, myocardial infarction (MI), heart failure (HF), ischemic stroke and diabetes was significantly higher in OH positive group than in OH negative group (all P < 0.05), however, antihypertensive medication was similar between the two groups.</p><p><b>CONCLUSIONS</b>Orthostatic hypotension is common in the elderly and retired population and is associated with increased risk of hypertension, diabetes mellitus and cardiovascular disease.</p>