ABSTRACT
Objective To investigate the prevalence of orthostatic hypotension in hypertensive patients aged 80 or over and associated risk factors at level A tertiary hospitals.Methods A multicenter cross-sectional study was conducted among very old hypertensive patients (≥ 80 years) at 28level A tertiary hospitals by using questionnaire-based surveys.A total of 1298 hypertensive subjects aged between 80 and 101 years were enrolled in this study.Blood pressures was measured in the supine position and the upright position within three minutes of standing,and 316 patients were assigned to the orthostatic hypotension(OH) group and the other 982 patients to the non-orthostatic hypotension(NOH) group.Additional information was acquired through patients' medical records and the questionnaire.Results The prevalence of OH was 24.3％ (316 cases) There were no significan different betueen OH patienl with NOHones in gender and age.OH patients had higher supine systolic and diastolic blood pressure(P=0.003 and 0.000,respectively),lower standing systolic and diastolic blood pressure(P=0.000 and 0.000,respectively),and higher rates of past coronary heart disease,stroke and renal abnormalities (P =0.037,0.001 and 0.014,respectively) than NOH patients.Logistic regression analysis showed that the prevalence of OH in the patients was positively correlated with supine systolic blood pressure(OR=1.196,CI:1.153-1.242,P=0.000) and supine diastolic blood pressure (OR =1.740,CI:1.602-1.885,P =0.000) and was negatively correlated with standing systolic blood pressure(OR =0.824,CI:0.795-0.855,P=0.000) and standing diastolic blood pressure (OR =0.584,CI:0.539-0.634,P =0.000).Conclusions The prevalence of orthostatic hypotension is high in hypertensive patients aged 80 years or over at level A tertiary hospitals.Poor blood pressure control may increase the risk of orthostatic hypotension.
ABSTRACT
Objective To evaluate the efficacy of CHOP (cyclophosphamide,doxorubicin,vincristine,and prednisone)chemotherapy on peripheral T cell lymphomas-unspecified (PTCL-U)in patients aged 80 years and over,and investigate the chemotherapy adverse effects and its prognostic factors.Methods Clinical data of 57 patients with PTCL-U confirmed by pathology and immunohistochemistry in Guangzhou First People's Hospital from January 2008 to January 2015 were retrospectively analyzed.The efficacy and adverse effects of CHOP chemotherapy,and its prognostic factors were evaluated.Results Of 57 patients,11 (19.3％) achieved complete remission,23(40.4％)had partial remission,14(24.6％)had stable disease,and 9(15.8％)had progressive disease after CHOP chemotherapy,with a total effective rate of 59.6％ (34 cases).The expected 1-year,2-year and 3-year overall survival(OS)rate was 70.2％ (40 cases),36.8％ (21 cases) and 17.5％ (10 cases),respectively.The median survival time was 18.2 months.Among the 57 patients,40(70.2％) had hypoplasia of bone marrow at degree Ⅰ-Ⅱ,17 (29.8％) at degree Ⅲ-Ⅳ,49 (86.0％) had mild nausea and vomiting(degree Ⅰ-Ⅱ),8(14.0％)had severe nausea and vomiting(degree Ⅲ-Ⅳ),7 had liver dysfunction,2 had cardiac toxicity and 7 had disturbance of blood coagulation.Univariate analysis showed that the alkaline phosphatase,Ki-67 percentage,lymphoma international prognostic index(IPI)score,extranodal involved sites(＞1),as well as the efficacy and course of chemotherapy were the prognostic factors for survival time in very elderly patients.Multivariate analysis indicated that IPI score＞2(95％CI:1.12～6.35,x2 ＝5.45,P＜0.01),extranodal involved sites(＞1)(95％ CI:2.58-15.32,x2 ＝ 16.42,P＜0.01),disease progression(95％CI:1.82～12.15,x2 ＝ 10.23,P＜0.01),chemotherapy courses(＞4) (5％CI:0.18～0.79,x2 ＝7.28,P＜0.01)were the independent prognostic factors for the median survival time in very elderly patients.Conclusions PTCL U patients aged 80 years and over have poor prognosis.CHOP chemotherapy has a certain effect on PTCL-U in very elderly patients,and chemotherapy side effects can be tolerated.IPI score＞2 and extranodal involved sites(＞ 1)are the important prognostic factors in very elderly PTCL-U patients.The completion of full course of chemotherapy with remission occurrence is important to prolong survival time in very elderly PTCL-U patients.