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@#As cognition declines with age, cognitive impairment rates are expected to increase ranging from 100% to 300% in this region. It could be higher among elderly who had any chronic diseases. The aim of the present work was to determine the prevalence and associated factors of cognitive impairment among elderly with hypertension. A clinic-based, cross-sectional study was conducted at several community clinics in Sabak Bernam and Hilir Perak districts from July to December 2015. A total of 480 patients were recruited. The prevalence of cognitive impairment was 13.13% (95%CI: 13.11, 13.15). Factors associated with cognitive impairment among elderly hypertensive were no formal educational level [OR: 3.95 (95%CI: 1.80, 8.67)]; history of high cholesterol [OR: 3.24 (95%CI: 1.15, 9.16)]; underweight [adj. OR: 4.88 (95%CI: 1.34, 17.67)]; and increasing age [OR: 1.03 (95%CI: 1.01, 1.06)]. Public health policy makers and geriatric practitioners should emphasise on early cognitive function assessment among elderlies who are hypertensive, unemployed, poor educational background, males, high cholesterol level and underweight to enhance the quality of geriatric services. Earlier establishment of diagnosis may prevent from greater rate of decline in cognitive functioning among this vulnerable group.
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Objective To discuss the efficacy and safety of urapidil combined with fructose injection in hypertensive elderly patients with acute heart failure(AHF).Methods Sixty-two elderly patients with acute heart failure complicated with hypertension from cardiovascular medicine of the fifth people's hospital of qinghai province were randomized into urapidil group (n =30)and urapidil combined with fructose treatment group (combined group,n =32).Two groups of patients were given regular heart failure treatment (oxygen,strong heart,diuresis,ACEI,etc),patients in urapidil group were treated with urapidil 50-100μg/min,48 h after continuous dosing,individualized adjust delivery time,dosing time adjustmented as individualized.On the basis of urapidil group,patients in combined group were treated with Fruc-tose-1,6-Diphosphate (FDP) injection of 5.0g,intravenous drip within 10 minutes,the duration was 7 days in two groups.The clinical efficacy was compared in two groups after treatment.Their parameters were compared before and on days 1,2,3 and 7 after treatment.The adverse reactions occur were recorded in patients of two groups during the treatment.Results There was no statistically significant difference in baseline data such as sex ratio,age,etc between the two groups (P ＞ 0.05).The total clinical efficacy rate in combined group was significantly higher than urapidil group(87.50％ vs 73.33％,x2 =6.102,P =0.047).The systolic pressure,diastolic blood pressure and heart rate of each time after treatment were gradually lower than before treatment in the two groups patients.These was no statistical significance difference in blood pressure and heart rate between the two groups at each time point after treatment (P ＞ 0.05).Compared with urapidil group,the left entricular ejection fraction (LVEF) and cardiac index (CI) were rised significantly.The left ventricular end systolic diameter (LVESD) and left ventricular end systolic volume (LVESV) were significantly decreased.The plasma N-terminal brain natriuretic peptide (NT-proBNP) was significantly reduced (P ＜ 0.05) in combined treatment group patients after treatment 7 days.There was no reflectively heart rateaccelerating in combined treatment group.Urapidil combined with fructose showed no bad influence on blood glucose,cholesterol and triglyceride.And combined treatment groups patients had significantly less side effects than their counterparts in urapidil group,but had no obvious statistical significance difference (10.00％ vs 3.13％,x2 =1.213,P =0.321).Conclusion Urapidil combined with fructose injection treatment hypertensive elderly patients with acute left heart failure demonstrated better efficacy and less side effects than urapidil alone on lowering and stabilizing systolic BP,improving cardiac function more significant.
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Objective To study the influence analysis of patients with anxiety and depression in elderly patients with hypertension antihypertensive effect of psychological intervention combined with Flupentixol and Melitracen Tablets.Methods 60 elderly patients with hypertension accompanied by anxiety and depression in our hospital from January 2014 to December 2016 were selected as the subjects.They were randomly divided into the control group and the experimental group, with 30 patients in each group.The control group was treated with conventional antihypertensive treatment, the experimental group were given psychological intervention combined with treatment of Flupentixol and Melitracen Tablets.The clinical indexes of the experimental group and the control group were compared and analyzed.Results After the corresponding treatment, the effective rate of antihypertensive treatment in the experimental group was 28 cases, and the effective rate of depressurization was 93.3%.The effective rate of antihypertensive treatment in the control group was 21, and the effective rate of antihypertensive treatment was 70%.After treatment, the HAMD score and HAMA score of the experimental group were significantly lower than those before the treatment, and the score of the experimental group was significantly lower than that of the control group, with statistical difference(P<0.05).Conclusion The treatment of elderly hypertensive patients with anxiety and depression in patients with better antihypertensive effect of psychological intervention combined with Flupentixol and Melitracen Tablets, can improve the depression and anxiety of patients in a large extent, high safety, is further applied in clinical significance.
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OBJECTIVE:To investigate the effect of prostaglandin E1 combined with atorvastatin on related indicators in elderly patients with hypertensive nephropathy. METHODS:70 elderly patients with hypertensive nephropathy were randomly divided into control group and observation group. Control group was orally given 10 mg Atorvastatin calcium tablet,once a day;observation group was additionally given 10 μg Prostaglandin E1 injection,adding into 250 ml 0.9% Sodium chloride injection by intravenous infusion,once a day. The treatment course for both groups was 2 weeks. All patients were given quality low-protein,low-salt and low cholesterol diet,depressurization,lipid-lowering and other conventional treatment. Heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure(DBP),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C),serum creatinine(Scr),24h urinary protein(TP/24 h),microalbuminuria(mAlb),uri-nary β2-microglobulin (β2-MG),blood urea nitrogen (BUN) before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:After treatment,HR,SBP,DBP,TG,TC and LDL-C in 2 groups were significantly lower than before,and difference was statistically significant(P0.05);Scr,TP/24 h,mAlb,β2-MG and BUN were signifi-cantly lower than before,and observation group was lower than control group,the differences were statistically significant(P0.05). CONCLUSIONS:Based on the con-ventional treatment,prostaglandin E1 combined with atorvastatin can effectively improve the HR,blood pressure and blood lipid of elderly patients with hypertensive nephropathy;however,prostaglandin E1 combined with atorvastatin is better than atorvastatin alone in aspect of protecting renal function,with similar safety.
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O envelhecimento é um processo caracterizado pela diminuição das funções fisiológicas e de todas as capacidades físicas. O objetivo do presente estudo foi verificar o efeito do exercício aeróbio e resistido sobre parâmetros hemodinâmicos, antropométricos e lipídicos de mulheres idosas hipertensas. Participaram do estudo 25 mulheres no grupo experimental (GE) (74,44 ± 6,3 anos) e 12 mulheres no grupo controle (GC) (75,25 ± 6,8 anos). O GE participou de sessões 60 minutos de exercícios físicos combinados com intensidade moderada que contemplaram alongamentos, exercícios localizados e caminhada, enquanto o GC manteve seus hábitos normais. Ao contrário do GC todas as variáveis analisadas no GE sofreram alterações significativa de (p<0,05) nos três momentos de intervenção, FCrep (85,0 ± 11,4 bpm; 80,1 ± 10,3 bpm; 79,4 ± 9,9 bpm), PAS (157,6 ± 13,9 mmHg; 142,8 ± 10,6 mmHg; 132,8 ± 8,4 mmHg), PAD (92,4 ± 7,2 mmHg; 88,0 ± 5,0 mmHg; 82,0 ± 4,1 mmHg), glicemia (110,2 ± 16,4 ml/dl; 101,3 ± 12,8 ml/dl; 95,3 ± 10,4 ml/dl), triglicerídeos (205,6 ± 37,7 ml/dl; 184,2 ± 32,5 ml/dl; 170,4 ± 29,2 ml/dl), colesterol total (223,2 ± 27,8 ml/dl; 205,3 ± 24,1 ml/dl; 196,4 ± 22,3 ml/dl), HDL (43,1 ± 1,5 ml/dl; 44,3 ± 1,5 ml/dl; 44,8 ± 1,4 ml/dl), VLDL (28,3 ± 3,2 ml/dl; 26,2 ± 2,5 ml/dl; 25,4 ± 2,2 ml/dl), LDL (151,8 ± 26,3 ml/dl; 134,9 ± 23,3 ml/dl; 126,2 ± 21,2 ml/dl). Concluiu-se que os exercícios físicos combinados foram eficientes nas melhorias das variáveis hemodinâmicas, antropométricas e lipídicas em idosas hipertensas.
Aging is a process characterized by decreased function physiological and all physical abilities. The purpose of this study was to assess the effect of aerobic exercise and resistance training on hemodynamic parameters, anthropometric and lipid in elderly hypertensive women. Participated in this study 25 women in experimental group (GE) (74,44 ± 6,3 years) and 12 women in control group (CG) (75,25 ± 6,8 years). GE participated in physical exercise sessions that included the combined practice of stretching, localized exercises and walking while CG remained normal daily habits. Unlike the CG all variables in the EG had significant changes in three moments of intervention, HRrest (85,0 ± 11,4 bpm; 80,1 ± 10,3 bpm; 79,4 ± 9,9 bpm), SBP (157,6 ± 13,9 mmHg; 142,8 ± 10,6 mmHg; 132,8 ± 8,4 mmHg), DBP (92,4 ± 7,2 mmHg; 88,0 ± 5,0 mmHg; 82,0 ± 4,1 mmHg), glucose (110,2 ± 16,4 ml/dl; 101,3 ± 12,8 ml/dl; 95,3 ± 10,4 ml/dl), triglycerides (205,6 ± 37,7 ml/dl; 184,2 ± 32,5 ml/dl; 170,4 ± 29,2 ml/dl), total cholesterol (223,2 ± 27,8 ml/dl; 205,3 ± 24,1 ml/dl; 196,4 ± 22,3 ml/dl), HDL (43,1 ± 1,5 ml/dl; 44,3 ± 1,5 ml/dl; 44,8 ± 1,4 ml/dl), VLDL (28,3 ± 3,2 ml/dl; 26,2 ± 2,5 ml/dl; 25,4 ± 2,2 ml/dl), LDL (151,8 ± 26,3 ml/dl; 134,9 ± 23,3 ml/dl; 126,2 ± 21,2 ml/dl). We concluded that exercise combination were effective in improvement of hemodynamic, anthropometric and lipid levels in elderly hypertensive.
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Humans , Female , Aged , Aged , Exercise , Hemodynamics , Hypertension , WomenABSTRACT
The cause of essential hypertension is yet unknown, but in general is caused by interaction of hereditary factors, diet, obesity, lack of exercise and stress. The aging process influences various physiological mechanism related to regulation of blood pressure. So elderly hypertensives have a tendancy to consider the disease as a result of the physiological aging process. This attitude causes many complications, worsening of the disease and even early death because of inappropriate care. In order to improve self-management of elderly hypertensives in this study the researcher examined the effect of blood pressure regulation by an education program that improves self-care behavior, through increasing self-efficacy. The education program consisted of group education on hypertension and self-care strategies, and encouraging and reinforcing self-efficacy resources such as verbal persuation, performance accomplishment and vicarious experiences. A quasi-experimental pre-and post-test design was used. Thirty-two elderly hypertensives participated in the study. Eighteen in the education group and fourteen in the control group. The education program consisted of eight sessions twice a week for four weeks. There was no intervention for the control group. Data were analysed using SPSS for Windows(Version 8.0). The results were as follows. 1. There was a significant decrease in systolic and diastolic blood pressure between the experimental group and control group over three different times, and interaction by groups and over time. 2. There was no significant difference in the level of self-care behavior between the experimental group and control group over three different times, and interaction by groups and over time. 3. There was significant difference in self-efficacy of experimental and control group, depending on the measuring period, but there was no difference between these groups on interaction by groups and over time. 4. There was positive correlation between self efficacy and self care behavior depending on the measuring period. There was negative correlation between diastolic blood pressure and self-care behavior on the posttest of the program, and between systolic blood pressure and self-care behavior on the follow-up test of the program. Findings indicate that this study will contribute to develop nursing strategies for the regulation of blood pressure for the elderly, which is easy for the elderly to learn as a nonpharmacologic approach.
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Aged , Humans , Aging , Blood Pressure , Diet , Education , Follow-Up Studies , Hypertension , Nursing , Obesity , Self Care , Self EfficacyABSTRACT
The effect of ketanserin, serotonin antagonist, among 19 korean patients over 55 years with essential hypertension was assessed in an open clinical trial for three months. patients were given Ketanserin 20mg bid with monthly follow-up visits. Mean values of systolic/diastolic blood pressures fell from 169+/-17/104+/-10mmHg to 155+/-14/94+/-9mmHg at 2 weeks(p<0.01) and to 147+/-10/87+/-6mmHg at end of treatment 12 weeks after(p<0.001). There was no significant change in heart rate. Transient mild side effects were observed in 5 patients. We conclude that Ketanserin is an effective and safe drug for the treatment of elderly hypertensives.