Association of systemic inflammatory response index with bone mineral density, osteoporosis, and future fracture risk in elderly hypertensive patients.

OBJECTIVES: This study sought to investigate the relationship between the systemic inflammatory response index (SIRI) and bone mineral density (BMD), osteoporosis, and future fracture risk in elderly hypertensive patients. METHODS: Elderly hypertensive patients (age ≥60 years) who attended our hospital between January 2021 and December 2023 and completed BMD screening were included in the study. Analyses were performed with multivariate logistic and linear regression. RESULTS: The multiple linear regression indicated that SIRI levels were significantly negatively correlated with lumbar 1 BMD (ß = -0.15, 95% CI: -0.24, -0.05), lumbar 2 BMD (ß = -0.15, 95% CI: -0.24, -0.05), lumbar 3 BMD (ß = -1.35, 95% CI: -0.23, -0.02), lumbar 4 BMD (ß = -0.11, 95% CI: -0.30, -0.10), femur neck BMD (ß = -0.11, 95% CI: -0.18, -0.05) and Ward's triangle BMD (ß = -0.12, 95% CI: -0.20, -0.05) among elderly hypertensive patients, after fully adjusting for confounders. Furthermore, we observed that SIRI was positively associated with future fracture risk in elderly hypertensive patients. Specifically, SIRI was associated with an increased risk of major osteoporotic fractures (ß = 0.33) and hip fractures (ß = 0.25). The logistic regression analysis indicated that there is an association between the SIRI level and an increased risk of osteoporosis (OR = 1.60, 95% CI = 1.37, 1.87), after fully adjusting for confounders. CONCLUSIONS: Our findings indicate a potential association between SIRI and BMD, osteoporosis, and the risk of future fractures in elderly hypertensive patients. However, further studies are warranted to confirm these findings.

Effects of intensive blood-pressure treatment on myocardial work in elderly hypertensive patients: A subcenter study of the STEP randomized controlled trial.

BACKGROUND: The benefits and safety of intensive blood pressure treatment in elderly hypertensive patients have been proved in the STEP trial. However, relevant mechanisms for intensive treatment are lacking. HYPOTHESIS: We aimed to explore whether intensive blood pressure treatment is associated with left ventricular systolic function changes as evaluated by myocardial work (MW) parameters in elderly hypertensive patients compared to the standard. METHODS: Patients were randomized to the intensive group (n = 66, median age 66 years, 42.4% male) with a systolic blood pressure (SBP) goal of 110 to <130 mmHg or the standard treatment group (n = 50, median age 63.5 years, 30% male) with an SBP goal of 130-<150 mmHg in this subcenter study of the STEP trial. There was no pre-randomization echocardiographic collected. Echocardiographic exam was produced at 1-year (phase 1) and 3-year (phase 2) post-randomization. RESULTS: In phase 1, SBP was already significantly lower in the intensive treatment group than in the standard treatment group (126.5 vs. 132.1 mmHg, p < .05). During a median follow-up of 40 months, in phase 2, the intensive group still had a lower SBP than the standard treatment group (125.0 vs. 135.3 mmHg, p < .05). Both global work index (GWI) and global constructive work (GCW) decreased significantly in phase in the intensive treatment group but not in the standard group (p < .05). Global wasted work (GWW) increased and global work efficiency (GWE) declined in both groups from phase 1 to phase 2 while no significant difference between the treatment effects. Similarly, left ventricular ejection function (LVEF) and global longitudinal strain (GLS) decreased in the two groups. The multivariate linear regression analysis showed the intensive treatment appeared to be an independent predictor of the ΔGWI (ß = -110.92; 95% CI, -197.78 to -30.07, p = .008) and ΔGCW (ß = -135.11; 95% CI, -220.33 to -49.88, p = .002). CONCLUSIONS: In elderly hypertensive patients, lower SBP was associated with decreased GWI and GCW and intensive BP treatment did not improve global MW efficiency.

The Influence of Diagnosis Intervention Packet Policy Intervention on Medication Structure and Drug Cost of Elderly Hypertensive Inpatients in China: A Multicenter Interrupted Time-Series Analysis.

Background: DIP is a new medical insurance payment system developed in China which was implemented in Guangzhou in January 2018, but few studies have focused on its intervention effect on the drug burden of elderly hypertensive patients. Methods: Nine medical institutions in Guangzhou, China, were selected, among which, daily full medical orders of elderly hypertensive inpatients from 2016 to 2020 were randomly collected. To assess the impact of DIP policy intervention on patient drug burden, we took the data after policy implementation in January 2018, as the intervention data, and applied a segmented regression model with interrupted time series to analyze the trend and changes in average daily drug costs per month and medication structure, stratified by age, sex, and inpatient department. Results: A total of 34,276 elderly hypertensive patients' daily full medical orders were obtained. The immediate level change of drug costs after intervention was -23.884 RMB/month (P = 0.652), and the trend change was statistically significant (-15.642 RMB/month, P = 0.002). The relative cumulative effect at the end of the study was -78.860% (95% CI: -86.087% to -69.076%), and the intervention effect was more significant in surgical and male patients. The analysis of drug structure changes showed that after the implementation of the DIP policy intervention, the proportion of anti-infective drugs, anti-tumor drugs, and biological products all showed a significant downward trend (P < 0.05), while nutritional drugs showed a significant upward trend (P = 0.011), but no immediate horizontal change in slope was observed. Conclusion: The typical practice in China showed that DIP policy intervention can improve the drug burden of elderly hypertensive hospitalized patients and has a stable long-term effect, and the intervention effect is not consistent across different clinical department and populations with different characteristics, and it would also cause changes in the medication structure.

The development of a self-management evaluation scale for elderly adults with hypertension based on the capability, opportunity, and motivation-behaviour (COM-B) model.

BACKGROUND: Using accurate assessment tools to assess patients in clinical practice is important to mining influencing factors and implementing interventions. However, most evaluation tools for the self-management of elderly patients with hypertension lack a theoretical basis and wide applicability, which makes the intervention effect insignificant. METHODS: Based on the Capability, Opportunity, and Motivation-Behaviour (COM-B) model, combined with literature review and qualitative research, a questionnaire item pool was initially formulated; then the initial items were screened and adjusted through expert consultation and pre-testing to form an initial scale. A field survey of 450 elderly hypertensive patients was then performed using the initial scale to test the reliability and validity of the scale. Cronbach's alpha, test-retest reliability and composite reliability were used to test the reliability of the scale, and the validity of the scale was evaluated from two aspects: content validity and construct validity. The evaluation results of the content validity of the scale by experts were used as the content validity index; the results of exploratory factor analysis and confirmatory factor analysis were used as the structural validity index to further verify the model structure of the scale and develop a formal scale. RESULTS: The final self-management scale included 4 dimensions and 33 items. The Scale-Content Validity Index was 0.920. Exploratory factor analysis extracted four factors that explained 71.3% of the total variance. Cronbach's alpha of the formal scale was 0.867, test-retest reliability was 0.894, and composite reliability of the 4 dimensions were within 0.943 ~ 0.973. Confirmatory factor analysis showed the scale had good construct validity. CONCLUSIONS: The Self-management Capability, Support and Motivation-Behaviour scale for elderly hypertensive patients has good reliability and validity, providing a tool for medical staff to evaluate the self-management level of elderly hypertensive patients.

A comparative study of antihypertensive drugs prediction models for the elderly based on machine learning algorithms.

Background: Globally, blood pressure management strategies were ineffective, and a low percentage of patients receiving hypertension treatment had their blood pressure controlled. In this study, we aimed to build a medication prediction model by correlating patient attributes with medications to help physicians quickly and rationally match appropriate medications. Methods: We collected clinical data from elderly hypertensive patients during hospitalization and combined statistical methods and machine learning (ML) algorithms to filter out typical indicators. We constructed five ML models to evaluate all datasets using 5-fold cross-validation. Include random forest (RF), support vector machine (SVM), light gradient boosting machine (LightGBM), artificial neural network (ANN), and naive Bayes (NB) models. And the performance of the models was evaluated using the micro-F1 score. Results: Our experiments showed that by statistical methods and ML algorithms for feature selection, we finally selected Age, SBP, DBP, Lymph, RBC, HCT, MCHC, PLT, AST, TBIL, Cr, UA, Urea, K, Na, Ga, TP, GLU, TC, TG, γ-GT, Gender, HTN CAD, and RI as feature metrics of the models. LightGBM had the best prediction performance with the micro-F1 of 78.45%, which was higher than the other four models. Conclusion: LightGBM model has good results in predicting antihypertensive medication regimens, and the model can be beneficial in improving the personalization of hypertension treatment.

Management of hypertension in the digital era: Perspectives and future directions / Gestión de la hipertensión en la era digital: perspectivas y direcciones futuras

Information and communication technology (ICT) have advanced remarkably in recent years. In the field of medicine, the problem of hypertension management seems especially well-suited to the application of novel methods. In patients with hypertension, it is important to assess blood pressure (BP) levels throughout the day and night, along with circadian BP variation, using out-of-office BP monitoring. ICT is an attractive tool to facilitate such monitoring and promises to change the current management of hypertension. The combination of self-telemonitoring of BP with lifestyle modification appears to be effective for strict BP control. ICT could be a solution to the challenging problem of nonadherence to antihypertensive medications and could reduce so-called clinical inertia in the treatment of hypertension. ICT approaches would be especially useful in geographically isolated areas or during natural disasters or complex health emergencies such as the ongoing coronavirus pandemic. However, it will be necessary to develop innovative ICT devices for easy and accurate BP measurement in a range of individuals, including the elderly, and to confirm their effectiveness in large scale clinical trials. ICT-based management of hypertension is expected to be pivotal for reducing the public-health burden of cardiovascular diseases and to be widely adopted in daily clinical practice in the future.

Las tecnologías de la información y la comunicación (TIC) han avanzado notablemente en los últimos años. En el campo de la medicina, el problema de la gestión de la hipertensión parece especialmente adecuado para la aplicación de métodos novedosos. En los pacientes con hipertensión, es importante evaluar los niveles de presión arterial (PA) a lo largo del día y de la noche, junto con la variación circadiana de la PA, mediante la monitorización de la PA fuera de la consulta. Las TIC son una herramienta atractiva para facilitar dicha monitorización y prometen cambiar el tratamiento actual de la hipertensión. La combinación de la autovigilancia de la PA con la modificación del estilo de vida parece ser eficaz para el control estricto de la PA. Las TIC podrían ser una solución al difícil problema de la falta de adherencia a la medicación antihipertensiva y podrían reducir la llamada inercia clínica en el tratamiento de la hipertensión. Los enfoques de las TIC serían especialmente útiles en zonas geográficamente aisladas o durante catástrofes naturales o emergencias sanitarias complejas como la actual pandemia de coronavirus. Sin embargo, será necesario desarrollar dispositivos TIC innovadores para medir la PA de forma fácil y precisa en una serie de individuos, incluidos los ancianos, y confirmar su eficacia en ensayos clínicos a gran escala. Se espera que la gestión de la hipertensión basada en las TIC sea fundamental para reducir la carga sanitaria de las enfermedades cardiovasculares y que se adopte ampliamente en la práctica clínica diaria en el futuro.

Management of hypertension in the digital era: Perspectives and future directions.

Information and communication technology (ICT) have advanced remarkably in recent years. In the field of medicine, the problem of hypertension management seems especially well-suited to the application of novel methods. In patients with hypertension, it is important to assess blood pressure (BP) levels throughout the day and night, along with circadian BP variation, using out-of-office BP monitoring. ICT is an attractive tool to facilitate such monitoring and promises to change the current management of hypertension. The combination of self-telemonitoring of BP with lifestyle modification appears to be effective for strict BP control. ICT could be a solution to the challenging problem of nonadherence to antihypertensive medications and could reduce so-called clinical inertia in the treatment of hypertension. ICT approaches would be especially useful in geographically isolated areas or during natural disasters or complex health emergencies such as the ongoing coronavirus pandemic. However, it will be necessary to develop innovative ICT devices for easy and accurate BP measurement in a range of individuals, including the elderly, and to confirm their effectiveness in large scale clinical trials. ICT-based management of hypertension is expected to be pivotal for reducing the public-health burden of cardiovascular diseases and to be widely adopted in daily clinical practice in the future.

Involvement of AGE and Its Receptors in the Pathogenesis of Hypertension in Elderly People and Its Treatment.

Both systolic and diastolic blood pressures increase with age up to 50 to 60 years of age. After 60 years of age systolic pressure rises to 84 years of age but diastolic pressure remains stable or even decreases. In the oldest age group (85-99 years), the systolic blood pressure (SBP) is high and diastolic pressure (DBP) is the lowest. Seventy percent of people older than 65 years are hypertensive. This paper deals with the role of advanced glycation end products (AGE) and its cell receptor (RAGE) and soluble receptor (sRAGE) in the development of hypertension in the elderly population. Plasma/serum levels of AGE are higher in older people as compared with younger people. Serum levels of AGE are positively correlated with age, arterial stiffness, and hypertension. Low serum levels of sRAGE are associated with arterial stiffness and hypertension. Levels of sRAGE are negatively correlated with age and blood pressure. Levels of sRAGE are lower in patients with arterial stiffness and hypertension than patients with high levels of sRAGE. AGE could induce hypertension through numerous mechanisms including, cross-linking with collagen, reduction of nitric oxide, increased expression of endothelin-1, and transforming growth factor-ß (TGF-ß). Interaction of AGE with RAGE could produce hypertension through the generation of reactive oxygen species, increased sympathetic activity, activation of nuclear factor-kB, and increased expression of cytokines, cell adhesion molecules, and TGF- ß. In conclusion, the AGE-RAGE axis could be involved in hypertension in elderly people. Treatment for hypertension in elderly people should be targeted at reduction of AGE levels in the body, prevention of AGE formation, degradation of AGE in vivo, downregulation of RAGE expression, blockade of AGE-RAGE interaction, upregulation of sRAGE expression, and use of antioxidants.

A nonlinear association between resting heart rate and ischemic stroke among community elderly hypertensive patients.

Background: Ischemic stroke is a major public health problem and a main cause of death in China. However, how resting heart rate may associate with ischemic stroke among patients with hypertension remains unclear.Objective: To investigate the association between resting heart rate and ischemic stroke among elderlies with hypertension in China.Methods: We conducted a retrospective study of elderlies with hypertension who aged ≥60 years and were free from a stroke at baseline. Resting heart rate at baseline was treated as both continuous and categorical variable. Hazard ratios for ischemic stroke were estimated by multivariate Cox proportional hazards models.Results: A total of 3071 elderlies with hypertension [1369 (44.6%) men, an average age of 71.3 ± 7.1 years] were enrolled, and 182 cases of ischemic stroke occurred during a mean follow-up period of 5.5 years. Multivariate Cox regression showed that every 10 bpm increment in resting heart rate elevated the risk of ischemic stroke by 21% (95%CI: 1.05, 1.73; P = 0.018). After adjusting for confounders, resting heart rate ≥90 bpm significantly associated with the risk of ischemic stroke (HR: 1.35, 95% CI = 1.16, 2.78) when using the resting heart rate <60 bpm as a referent. Subgroup analysis showed that the relation between resting heart rate and risk of ischemic stroke was seem to be stronger in female (HR: 1.32 vs 1.11), those with uncontrolled hypertension (HR: 1.32 vs 1.12), people with combined diabetes and hypertension (HR: 1.31 vs 1.12), people with overweight (HR: 1.39 vs 1.02) and those who aged >75 (HR: 1.33 vs 1.11). Smoothing spline plots suggested the optimal resting heart rate for the lowest risk of ischemic stroke was between 60 and 80 bpm.Conclusions: In Chinese elderly hypertensive patients, elevated resting heart rate was an independent predictor of ischemic stroke, and the optimal resting heart rate was around 70 bpm.

Effect of Classical Music on Blood Pressure in Elderly With Hypertension in Bina Bhakti Werdha Elderly Nursing Home, Indonesia

@#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.

Clinical significance of thromboelastography in elderly hypertensive patients / 国际检验医学杂志

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.

Home blood pressure and cardiovascular outcomes in very elderly patients receiving antihypertensive drug therapy: a subgroup analysis of Home blood pressure measurement with Olmesartan Naive patients to Establish Standard Target blood pressure (HONEST) study.

The appropriate target blood pressure (BP) in elderly patients with hypertension remains uncertain. We investigated the relationship between morning home systolic blood pressure (MHSBP) during follow-up and cardiovascular (CV) risk in outpatients receiving olmesartan-based treatment aged <75 years (n = 16799) and ≥75 years (n = 4792) in the HONEST study. In the follow-up period (mean 2.02 years), the risk for major CV events was significantly higher in patients with MHSBP ≥155 mmHg compared with <125 mmHg in both age groups in Cox proportional hazards model adjusted for other risk factors and there was no significant difference in trend between the two groups (interaction P = 0.9917 for MHSBP). Hazard ratios for CV events for 1-mmHg increase in MHSBP were similar in patients aged <75 years and in patients aged ≥75 years. The incidence of adverse drug reactions related to excessive BP lowering was lower in patients <75 years than in patients ≥75 years (0.73 vs 1.02%, P = 0.0461). In conclusion, the study suggests even in patients ≥75 years antihypertensive treatment targeting the same MHSBP levels in patients <75 years may be beneficial in reducing CV risk when treatment is tolerated.

Hypertension in the Older Adult.

Hypertension is common among adults and is associated with significant morbidity and mortality and should be routinely addressed in primary care practice. Optimal blood pressure targets have evolved in the past decade with the release of large studies including older persons. However, controversy remains regarding the treatment of older and frail patients. The relationship between blood pressure treatment and falls or cognitive impairment is still an area of concern and debate. A strategy to address hypertension in older persons should consider an individual's fitness and the likelihood of adverse effects and worsening of conditions that adversely affect quality of life.

Influência dos treinamentos aeróbio e resistido sobre os parâmetros metabólicos e cardiovasculares de mulheres idosas / Influence of aerobic and resistence training on the cardio-vascular and metabolic parameters in elderly women / Influencia del entrenamientos aeróbico y resistido en los pa-rámetros metabolico y cardiovascular de mujeres de edad avanzada

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.

Intervention effects of cognitive-behavioral group counseling in the elderly hypertension with anxiety symptoms / 中国心理卫生杂志

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.

Clinical Observation of Atorvastatin Combined with Levamlodipine Besylate in the Treatment of Elderly Patients with Hypertension Combined with Carotid Plaque / 中国药房

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.

Clinical analysis on the relationship of orthostatic hypotension in elderly hypertensive patients with left ventricular structure and function / 中华老年医学杂志

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.

Effects of valsartan and amlodipine on urinary microalbumin in elderly patients with hypertension / 中国生化药物杂志

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.

Curative effect analysis of routine western medicine combined with psychological intervention in treatment of senile hypertension / 中国生化药物杂志

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.