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Is treated hypertension associated with a lower 1-year mortality among older multimorbid residents of long-term care facilities?
Kantoch, Anna; Pac, Agnieszka; Wizner, Barbara; Wójkowska-Mach, Jadwiga; Heczko, Piotr; Grodzicki, Tomasz; Gryglewska, Barbara.
  • Kantoch A; Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Faculty of Medicine, University Hospital in Kraków, Kraków, Poland
  • Pac A; Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  • Wizner B; Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Faculty of Medicine, University Hospital in Kraków, Kraków, Poland
  • Wójkowska-Mach J; Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  • Heczko P; Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  • Grodzicki T; Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Faculty of Medicine, University Hospital in Kraków, Kraków, Poland
  • Gryglewska B; Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Faculty of Medicine, University Hospital in Kraków, Kraków, Poland. barbara.gryglewska@uj.edu.pl
Pol Arch Intern Med ; 131(5): 439-446, 2021 05 25.
Article in English | MEDLINE | ID: covidwho-1267006
ABSTRACT

INTRODUCTION:

Long-term care facility (LTCF) residents are typically excluded from clinical trials due to multimorbidity, dementia, and frailty, so there are no clear evidence-based rules for treating arterial hypertension in this population. Moreover, the role of hypertension as mortality risk factor in LTCFs has not yet been clearly established.

OBJECTIVES:

The study aimed to investigate whether treated hypertension is associated with lower mortality among older LTCF residents with multimorbidity. PATIENTS AND

METHODS:

The study was performed in a group of 168 residents aged ≥ 65 years in three LTCFs. Initial assessment included blood pressure (BP) measurements and selected geriatric scales MNA-SF, AMTS and ADL. Hypertension, comorbidities, pharmacotherapy, antihypertensive drugs and mortality during one-year follow-up were extracted from the medical records. The data was compared in groups Survivors and Deceased.

RESULTS:

Survivors and Deceased revealed similar age, DBP, number of diseases, medications, and antihypertensive drugs. However, Deceased had significantly lower SBP (P <0.05) and presented significantly worse functional, nutritional and cognitive status than Survivors (P <0.001). Hypertension (P <0.001) and antihypertensive therapy (P <0.05) were significantly more frequent among Survivors. Significantly more of the hypertensive-treated than other multimorbid residents survived the follow-up (P <0.001). Logistic regression analysis showed that treated hypertension had a protective effect on mortality [OR = 0.11 (95% CI, 0.03-0.39); P <0.001].

CONCLUSIONS:

One-year survival of LTCF residents with treated hypertension was significantly higher than the others. Appropriate antihypertensive therapy may be a protective factor against death in frail nursing home residents, even in short period of time.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Long-Term Care / Hypertension Type of study: Cohort study / Etiology study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Humans Language: English Journal: Pol Arch Intern Med Year: 2021 Document Type: Article Affiliation country: Pamw.15944

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Long-Term Care / Hypertension Type of study: Cohort study / Etiology study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Humans Language: English Journal: Pol Arch Intern Med Year: 2021 Document Type: Article Affiliation country: Pamw.15944