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@#One of the vascular disorders that occurs in the elderly is hypertension. The most severe consequence of this complications is stroke. Prevention of hypertension with non-pharmacological therapy like listening to classical music (eg. Mozart). Classical music can stimulate alpha waves in the brain, releasing a peptide called beta-endorphin. This causes a sense of tranquility so that the heart rhythm decreases, and blood pressure drops. The sample in this study were 17 respondents, aged over 60 years. The result of this case report showed an average systolic reduction of 21 mmHg. Before intervention, 53% suffered from stage 2 hypertension (mean systolic 162 mmHg) and after the intervention with classical music therapy for 12 days, 65% recovered with stage 1 hypertension (average systolic 141 mmHg). So, the interventions of listening to classical music, can maintain balance in blood pressure among hypertension patient.
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Objective To explore the clinical significance of thromboelastography (TEG) in detecting coagulation status in elderly hypertensive patients.Methods A total of 75elderly patients with hypertension, were selected as the elderly hypertensive group.Meanwhile, 60cases of senile cerebral infarction patients and 47cases of normal elderly were selected as the senile cerebral infarction group and the normal elderly group respectively.The values of R, MA, α-Angle, K, CI were measured by TEG-5000thrombus elastometer and then compared in the three groups.Meanwhile, the values of platelet inhibition induced by AA and ADP were also detected in the elderly hypertensive group.The PLT and WBC of the elderly hypertensive group were detected by automatic five class blood cell analyzer.The correlation between TEG parameters and PLT and WBC in elderly hypertensive group were analyzed.Results Compared with the normal elderly group, the MA and CI of the elderly hypertensive group were significantly increased (P＜0.05), theα-Angle and K were significantly decreased (P＜0.05), the R value was not significantly different (P＞0.05), while in the senile cerebral infarction group, the R was significantly shortened (P＜0.05), the CI was significantly increased (P＜0.05) and the K value was significantly decreased (P＜0.05).Compared with the elderly hypertensive group, the R value of the aged cerebral infarction group was shortened (P＜0.05).In the elderly hypertensive group, PLT were negatively correlated with MA, α-Angle and CI, negatively correlated with K value, and not related to R value.WBC was positively correlated with MA, α-Angle and CI, negatively correlated with K value, and low correlation with R value.The proportion of patients ADP inhibition rate≥30％was 41.94％ (13/31), while the proportion of patients AA inhibition rate≥50％was 20.00％ (8/40).Conclusion The detection of TEG is of great significance in helping the clinical diagnosis, treatment guidance and disease monitoring of elderly hypertension, and can prevent the occurrence of complications of hypertension in the elderly hypertensive patients.
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Este estudo busca verificar a influência do treinamento aeróbio (TA) e resistido (TR) sobre parâmetros metabólicos e cardiovasculares, além da prevalência de fatores de risco cardiovasculares em idosas. O estudo foi realizado com 39 mulheres (68,6±6,2 anos) submetidas ao TA e TR, 3x/semana por 13 semanas. Obteve-se redução da pressão arterial (PA) sistólica (-7,8mmHg, p=0,01), da PA diastólica (-2,1mmHg, p=0,04), da prevalência de hipertensão arterial (p=0,04), da frequência cardíaca de repouso (-4bpm, p=0,03), do duplo produto (-843,3mmHgxbpm, p=0,02) e tendência de redução da glicose sanguínea (p=0,06). Porém, houve manutenção dos parâmetros lipídicos. Assim, o treinamento ocasionou melhora cardiovascular e tendência na redução da glicemia, sem melhorias no perfil lipídico.
This study aims to verify the influence of aerobic training (AT) and resistance (RT) on meta-bolic and cardiovascular parameters and the prevalence of cardiovascular risk factors in elder-ly women. The study was conducted with 39 women (68.6±6.2 years old) subjected to AT and RT 3x/week, for 13 weeks. It were obtained reductions of systolic blood pressure (BP) (-7.8mmHg, p=0.01), diastolic BP (-2.1mmHg, p=0.04), the prevalence of arterial hypertension (p=0.04) the resting heart rate (-4bpm, p=0.03), rate-pressure product (-843.3mmHgxbpm, p=0.02) and blood glucose decrease trend (p=0.06). However, there was maintenance of lipid parameters. Thus, the training caused cardiovascular improvement and trend in reducing blood glucose levels without improvement in the lipid profile.
Este estudio tiene como objetivo verificar la influencia del entrenamiento aeróbico (EA) y la resistencia (ER) en los parámetros metabólicos y cardiovasculares, y la prevalencia de facto-res de riesgo cardiovascular en mujeres de edad avanzada. El estudio fue realizado con 39 mujeres (68,6±6,2 años) sometidos al EA y ER 3x/semana y durante 13 semanas. Reducción obtenida de la presión arterial (PA) (-7,8mmHg, p=0,01), la PA diastólica (-2,1mmHg, p=0,04), la prevalencia de la hipertensión (p=0,04) de frecuencia cardíaca en reposo (-4bpm, p=0,03), el doble producto (-843,3mmHgxbpm, p=0,02) y la reducción de la glucemia ten-dencia (p=0,06). Sin embargo, hubo mantenimiento de los parámetros de lípidos. Por lo tanto, la formación y la llevó tendencia de mejora cardiovascular en la reducción de los niveles de glucosa en la sangre sin la mejora en el perfil lipídico.
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Humans , Female , Aged , Exercise , Health of the Elderly , Chronic Disease/prevention & controlABSTRACT
Objective To investigate the effect of valsartan and amlodipine on urinary microalbumin in elderly hypertensive patients. Methods 100 elderly patients with hypertension treated in our hospital from May 2015 to October 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The patients in the control group received oral valsartan, and the patients in the experimental group were treated with valsartan and amlodipine. The treatment time of the experimental group and the control group was 12 weeks. The clinical indexes of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the experimental group and the control group did not have obvious adverse reactions. There were 2 cases of headache in the experimental group, 1 cases of vertigo, and 2 cases of vertigo in the control group. However, there was no significant difference in the incidence of adverse reactions between the experimental group and the control group, and there was no statistical significance. The antihypertensive effect of the experimental group was significantly higher than that of the control group, with statistical significance (P<0.05). After treatment, the urinary microalbumin in the experimental group and the control group was significantly lower than that in the treatment group, and the level of microalbuminuria in the experimental group was lower than that in the control group, with statistical significance (P<0.05). Conclusion The clinical effect of treatment of elderly patients with hypertension better combined with valsartan and amlodipine, antihypertensive effect is stronger, can significantly improve the patient's urinary albumin, with further clinical promotion and application significance.
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Objective To study and analyze the treatment effect of routine western medicine combined with psychological intervention on senile hypertension. Methods 100 elderly patients with hypertension in our hospital from February 2015 to October 2016 were selected as the subjects. They were randomly divided into the control group and the experimental group, with 50 patients in each group. The patients in the control group were given Kato Pury treatment, and the experimental group was given psychological intervention on the basis of the control group, and pay attention to the psychological state of the patients. The therapeutic effects of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the SAS score and SDS score of the experimental group were (41.09±2.26), respectively (38.92±2.15). The SAS score and SDS score of the control group were (53.18±2.41), respectively (48.19±2.56). The scores of SAS and SDS in the experimental group were significantly higher than those in the control group, with statistical significance (P<0.05). The experimental group patients with diastolic blood pressure (84.19±3.18) mmHg, systolic blood pressure (131.92±11.64) mmHg diastolic blood pressure was significantly better than the control group (90.11±4.11) mmHg and systolic blood pressure (148.28±12.39) mmHg, with statistical difference(P<0.05). Conclusion The conventional western medicine combined with psychological intervention in treatment of senile hypertension treatment effect is better, can significantly improve the depression and anxiety of patients, blood pressure control, with further clinical promotion and application significance.
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Objective:To evaluate the effects of the intervention of cognitive-behavioral group counseling for elderly hypertensive patients with anxiety symptoms.Methods:The Screen for Self-Rating Anxiety Scale (SAS) of higher scores ≥41 was used to screen out 80 elderly hypertensive patients with anxiety symptoms,who were randomly signed to the intervention group (n =40) and the control group (n =40).The intervention group was given cognitive-behavioral group counseling for 8 weeks,while the control group without any intervention.All participants were assessed with the State-Trait Anxiety Inventory (STAI),Simplified Coping Style Questionnaire (SCSQ),UCLA Loneliness Scale and Self-Esteem Scale (SES) at base line,8 weeks after the intervention and one month after the end of intervention.Results:Thirty-seven elderly hypertensive patients of the intervention group completed the 8-week sessions and 32 elderly hypertensive patients participated in the l-mouth follow-up.Thirty-nine participants of the control group completed the 8-week wait and post 8-week wait follow-up diagnostic tests.Compared to baseline,the patients had significant reduction in the scores at SAI and negative coping style after treatment (Ps ＜ 0.01),whereas the scores of those in the control group did not show any significant reduction (Ps ＞0.05).In the comparison of before-post difference between intervention and control group,the difference of SAI scores and negative coping style scores were higher inintervention group than in control group (Ps ＜ 0.05).The 1-month follow-up showed that the scores of SAIand negative coping style decrease continuously (Ps ＜ 0.01).Contusion:It suggests that cognitive-behavioral group counseling could reduce the level of anxiety in the elderly hypertensive patients.
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OBJECTIVE:To observe the clinical efficacy and safety of atorvastatin combined with levamlodipine besylate in the treatment of elderly patients with hypertension combined with carotid plaque. METHODS:160 elderly patients with hyperten-sion combined with carotid plaque were randomly divided into control group(80 cases)and observation group(80 cases). Control group orally received Atorvastatin tablet 3 mg,qd+compound reserpine tablets 2 tablets,tid;observation group was received Atorv-astatin tablet(the same dosage and usage with control group)+Levamlodipine besylate tablet 2.5 mg,qd. They were treated for 8 months. Antihypertensive efficacy,blood pressure,and carotid intima-media thickness (IMT) before and after treatment,and the incidence of adverse reactions in 2 groups were observed and recorded. RESULTS:The antihypertensive effective rate in observa-tion group was significantly higher than control group,with statistical significance(P0.05). After treatment,blood pressure and IMT levels in 2 groups were significantly lower than before,and observation group was lower than control group,with statistical significance(P0.05). CONCLUSIONS:Atorv-astatin combined with levamlodipine besylate shows good efficacy in the treatment of elderly patients with hypertension combined with carotid plaque,which can not only effectively control patients'blood pressure,but also improve atherosclerosis,reversing plaques and does not increase the incidence of adverse veactions.
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Objectives To explore the relationship of orthostatic hypotension in elderly hypertensive patients with left ventricular structure and function.Methods 101 cases of elderly patients with hypertension were selected from July 2013 to June 2015.After blood pressure measurement in vertical and decubitus position,all patients were divided into non-orthostatic hypotension and orthostatic hypotension groups,received the echocardiography and the accurate calculation of left ventricular mass index.Results Compared with non-orthostatic hypotension,orthostatic hypotension in patients with left ventricular diastolic diameter,left ventricular posterior wall thinckness and interventricular septum thickness.Left ventricular mass index significantly increased(48.13±5.54)mm vs.(52.45 ± 1.48)mm in left ventricular diastolic diameter,(10.08± 1.87)mm vs.(11.29± 1.98)mm in left ventricular posterior wall thickness,(10.18± 1.88)mm vs.(11.61±1.66) mm in interventricular septum thickness,and (114.59 ± 22.72) g/m2 vs.(131.98 ± 23.43)g/m2 [t=4.386、2.985、4.397、8.672,in left ventricular mass index(BMI),all P＜0.05].Left heart ventricular ejection fraction and mitral peak early/late diastolic blood flow decreased [(60.81 ± 4.73)vs.(53.60±2.58)and(0.93±0.23)vs(0.76±0.26)t=4.298、3.654,all P＜0.05].Conclusions There is relationship of orthostatic hypotension with left ventricular structure and function in elderly hypertension patients,and it is essential not only to control blood pressure effectively,but also to focus on controlling orthostatic hypotension.
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Objective To explore the effect of health education on medication compliance of middle-aged and elderly hypertensive patients in rural areas. Methods Outpatients aged 45 hypertensive patients were divided into two groups, the intervention group was given health education knowledge, intervention of bad habits and knowledge of drug by oral presentations, banner ads, TV screen publicity, publicity, newspaper, telephone follow-up and other forms of propaganda. Results Hypertension knowledge, dietary knowledge, living habits, medication knowledge, medication compliance of patients in the intervention group were increased significantly, and there were significant difference in the four survey in the observation group with statistical significance(P<0.05). Conclusion Health education has a great influence on drug compliance among middle-aged and elderly hypertensive patients in rural areas, and has great significance for controlling blood pressure.
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OBJECTIVE:To observe the clinical efficacy and safety of candesartan combined with amlodipine besylate in the treatment of elderly hypertension. METHODS:Totally 156 elderly patients with hypertension were randomly divided into control group and observation group. Patients in control group were orally given Amlodipine besylate tablets 5 mg in the morning,once a day. Patients in observation group were orally given Candesartan tablets 8 mg based on the treatment of control group,once a day. The course of both was 8 weeks. The clinical data was observed,including clinical efficacy,systolic blood pressure(SBP)and dia-stolic blood pressure(DBP)before and after treatment,fasting blood glucose(FPG),insulin resistance index(HOMA-IR),24 h urinary albumin total(mAlb),serum creatinine(SCr)and the incidence of adverse reactions. RESULTS:The total effective rate in observation group was significantly higher than control group;the HOMA-IR,mAlb and SCr in observation group were significant-ly lower than control group,with significant difference(P0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Candesartan combined with amlodipine besylate has better efficacy than only amlodipine besylate in the treatment of elderly hypertension,with similar safety.
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Objective To observe the regularities of distribution of TCM syndrome types and correlation between TCM syndrome types and cardiovascular prognosis risk factors of elderly hypertensive patients in three different urban and rural communities.Methods Totally 299 elderly hypertensive patients who conformed to the hypertensive diagnostic criteria from 896 respondents which participated in the health monitoring questionnaire drafted by health management team of China Academy of Chinese Medical Sciences were screened. The syndrome types were differentiated according to Guiding Principle of Clinical Research on New Drugs of Traditional Chinese Medicine (for Trial Implementation). The levels of some risk indicators, such as blood glucose, blood lipid, CREA, ET, Hcy and mALB were measured by radioimmunoassay, enzymatic cycling assay and other methods. Age, gender, BMI and pulse pressure were recorded.Results The TCM syndrome types of 299 elderly hypertensive patients were deficiency of yin and yang type (74 cases), hyperactivity of yang due to yin deficiency type (65 cases), blood stasis syndrome type (62 cases), stagnation of phlegm-dampness type (61 cases), hyperactivity of liver-fire type (37 cases). Single factor analysis showed that there existed statistical significance among BMI, FBG, GHbA1c, CREA, TC, LDL-C, ET, Hcy and mALB in the 5 TCM syndromes (P<0.05,P<0.01), and the statistical significance was more apparent in the stagnation of phlegm-dampness type, blood stasis syndrome type and hyperactivity of yang due to yin deficiency type. Discriminant analysis showed BMI and Hcy have certain reference value for the diagnosis of TCM syndrome types in elderly hypertensive patients. Binary-Logistic regression analysis showed that the course of disease had a positive correlation with syndrome of deficiency of yin and yang.Conclusion Compared with other types of elderly hepertensive patients, stagnation of phlegm-dampness type and blood stasis syndrome type are more closely related to hypertension cardiovascular prognosis risk factors.
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Objective To observe the clinical efficacy of Bushen Huoxue Decoction on elderly hypertension of kidney deficiency and blood stasis syndrome. Methods Totally 106 patients with elderly hypertension of kidney deficiency and blood stasis syndrome were divided into control group (53 cases) and treatment group (53 cases), according to random number table method. The control group was treated with routine western medicine, while the treatment group was given Bushen Huoxue Decoction along with western medicine treatment for 8 weeks. The changes of TCM syndrome, blood pressure, TG, TC, LDL-C, HDL-C, high sensitivity C reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) before and after treatment of the two groups were observed. Results The total effective rate of anti-hypertension was 94.33%(50/53) in the treatment group and was 77.35% (41/53) in the control group. The total effective rate of clinical symptoms was 96.22%(51/53) in the treatment group and was 79.24%(42/53) in the control group. After treatment, TG, TC, LDL-C, HDL-C, hs-CRP, IL-6, and TNF-α were improved significantly in the treatment group, with statistical significance compared with the control group (P<0.05). Conclusion Bushen Huoxue Decoction combined with western medicine achieves the good efficacy on elderly hypertension of kidney deficiency and blood stasis syndrome.
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Both hypertension and aging impact renal function. Elderly patients are more likely to have chronic kidney disease (CKD), usually defined by estimated glomerular filtration rate 60 mL/min/1.73 m2. Multiple studies over the past two decades have shown that CKD is a powerful cardiovascular disease (CVD) risk factor. Reduced kidney function in elderly people is a marker for adverse outcomes. The major goals of lowering blood pressure (BP) in patients with CKD include reduction of mortality, CVD events and slowing progression. Main considerations in the management of hypertension include selection of a target BP and selection of agents used to attain the chosen target. Current clinical practice guidelines for BP targets and choice of anti-hypertensive agents in elderly patients with CKD are not specific. Older patients with CKD might experience increased mortality and hospitalizations in association with lower baseline BP values. This review outlines controversies in applying current guidelines for the management of BP to older patients with CKD. Because of the high burden of other comorbidities in older patients with CKD, strict adherence to guidelines for the management of hypertension may not always represent the most adequate approach.
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Aged , Humans , Aging , Antihypertensive Agents , Blood Pressure , Cardiovascular Diseases , Comorbidity , Glomerular Filtration Rate , Hospitalization , Hypertension , Kidney , Renal Insufficiency, Chronic , Risk FactorsABSTRACT
BACKGROUND: Clinic-based blood pressure measurements may lead to untoward results in the management of hypertension. Masked hypertension (MH) has been shown to be related to a poor prognosis due to its hidden nature. The purpose of this study is to present the clinical predictors of MH in elderly patients over 65 years with well-controlled clinic blood pressure (CBP) and to evaluate the gap, the 'mask effect' (negative white-coat effect), between CBP and home blood pressure (HBP). METHODS: The BPs of 1,019 treated hypertensive patients were measured by a doctor at an out-patient clinic and by patients themselves at home. Clinical parameters for MH were analyzed in 511 patients with well-controlled CBP (45.6% men, mean age 57.1+/-9.0 years). RESULTS: Among the patients over 65 years (n=113, 46.8% men, mean age 68.4+/-7.3 years) and with well-controlled CBP, the prevalence of MH was 26.5% (30 patients). In multivariate-adjusted analysis, the risk of MH increased with physical inactivity (odds ratio [OR], 2.942; 95% confidence interval [CI], 1.039-8.329; p=0.042), use of beta-blocker (OR, 4.242; 95% CI, 1.528-11.785; p=0.06) and systolic clinic BP (OR, 1.083; 95% CI, 0.017-1.154; p=0.013). Furthermore, HBP correlated well with CBP (r=0.329; p<0.001) and further with degree of ME (r=0.723; p<0.001). CONCLUSION: In looking for MH, it would be useful to carefully assess patients taking beta-blockers, having higher CBP, and who are physically inactive by using self-monitoring home or ambulatory BP monitoring.
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Aged , Humans , Male , Blood Pressure , Hypertension , Masked Hypertension , Masks , Outpatients , Prevalence , PrognosisABSTRACT
@#Objective To evaluate the effect of health education on the old male patients with primary hypertension.Methods 120 old male patients with primary hypertension were randomly selected from the whole group and educated with health knowledge related to blood hypertension, and the changes of life style and blood pressure after health education were recorded.Results Most of the patients changed their unhealthy life style. Among these patients, more than 80% were able to have a stable emotion, regular daily life, stop smoking and less drinking, there were 66% cases with a healthy diet. The systolic pressure of the patients declined significantly after health education (P<0.01).Conclusion The health education is an efficient way to control hypertension in the official-service outpatient department.
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Objective To analyse the distribution and evolution law of TCM syndrome for elderly hypertension (EH), to provide evidence for syndrome standardization study. Methods Case history of 2 029 EH patients during recent ten years were investigated in the way of epidemiology. The main and complicated syndrome types were studied. Results The main syndrome types of EH were yin deficiency of liver and kidney (40.0%), kidney qi deficiency (28.4%), hyperactivity of liver-yang (9.7%), excessive accumulation of phlegm-dampness (7.4%), collateral obstruction by blood stasis (6.6%), phlegm and blood stasis (5.7%), liver-fire hyperactivity (1.1%). The complicated syndrome types were liver-fire hyperactivity (26.5%), excessive accumulation of phlegm-dampness (9.6%), collateral obstruction by blood stasis (7.2%), phlegm and blood stasis (5.5%), kidney yin deficiency (3.7%). Conclusion The distribution of EH TCM syndrome is mainly about deficiency syndromes, in which kidney qi deficiency syndrome is very common, and mostly complicated with phlegm and blood.
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Objective: To explore the feasible methods for item selection of TCM syndrome scale.Methods:Elderly hypertension with syndrome of kidney qi deficiency was selected as example.The symptoms and signs of elderly hypertension patients were statistically analyzed with clinical epidemiological investigation on the basis of discussion among focus group and expert consultation.Six selection methods were used,such as correlation coefficient method,dispersion tendency method,factor analysis method,etc.Results:18 Items were selected in the end and constituted the preliminary scale of kidney qi deficiency of elderly hypertension.Conclusion:Only if combine subjective and objective selection methods,use kinds of proper statistical methods and master the scale of preserving items,can we acquire good reliability and validity of scale.
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Objective To investigate the changes of plasma fibrinolytic activity and D dimer level in the primary hypertension of the elderly.Methods ELISA was applied to measure blood and urine D dimer.Chromophore substrate method was used to detect PL,Plg,t PA and PAI 1.Results The levels of PAI 1,D dimer and Plg were obviously higher in the elderly primary hypertension and hypertentive kidney disease than those in the control group,while t PA and PL activity were lower than in the control group.Conclusion The changes of PLA and D dimer play an important role in hypertension and hypertentive renal disease of the elderly,on which the early diagnosis can be based.
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By using radioligand binding assay, the maximal binding capacity ( Bmax ) and irritability (KD) of receptors of the peripheral lymphocytes from 53 normotensives and 70 hypertensives aged from 38 to 94 years were measured. In the meanwhile, hemodynamic parameters were determined in a part of patients. It was shown that both Bmax and KD of the receptors of the lymphocytes in normotensive people did not change with aging and sex. However, the elderly hypertensive patients had a significantly lower Bmax than age-matched normal controls and middle-aged hypertensive patients. There were no significant linear correlation between adrenoceptor Bmax and hemodynamic parameters. Conclusion:The decreased density of p-adreno-ceptor may contribute to the pathogenesis of hypertension in the elderly, but It docs not play an important role