A. Turusheva, Y. Kotovskaya, E. Frolova, Т. A. Bogdanova, O. Kutznetsova
{"title":"高血压对死亡率和老年综合征发生风险的影响","authors":"A. Turusheva, Y. Kotovskaya, E. Frolova, Т. A. Bogdanova, O. Kutznetsova","doi":"10.18705/1607-419x-2022-28-4-419-427","DOIUrl":null,"url":null,"abstract":"Background. Hypertension (HTN) is a major risk factor for the development of cardiovascular disease in young and middle age, however, data on its effect on cardiovascular risk in older adults are contradictory. Objective. To evaluate the impact of high blood pressure on mortality and the course of major geriatric syndromes in the population aged 65 years and older. Design and methods. The prospective cohort Crystal study (2 examinations, 9 years of follow-up), the cross-sectional cohort Eucalyptus study. Sample: a random sample of community-dwelling older adults aged 65 and older (n = 1007). Main parameters: blood pressure, analysis of drug treatment, medical history, laboratory tests, comprehensive geriatric assessment. Results. HTN has been identified as a risk factor for myocardial infarction, cognitive decline, slow gait speed and low muscle strength. However, in people with frailty and slow gait speed, the presence of HTN was associated with a lower risk of all-cause mortality. The lowest risk of all — cause mortality in participants with a slow gait speed was found with systolic blood pressure 140-159 mm Hg [risk ratio (95 % confidence interval) 0,049 (0,009-0,283)], with frailty — with systolic blood pressure 160-180 mm Hg [risk ratio (95 % confidence interval) = 0,109 (0,016-0,758)]. Conclusions. HTN retains its negative predictive value in older adults and is associated with an increased risk of cardiovascular complications, decreased cognitive and physical functions, but a lower risk of mortality in people with frailty and a low level of physical function. An individual approach and an obligatory assessment of the level of physical function in older patients are required when prescribing antihypertensive therapy.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"245 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2022-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The impact of hypertension on mortality and the risk of developing geriatric syndromes\",\"authors\":\"A. Turusheva, Y. Kotovskaya, E. Frolova, Т. A. Bogdanova, O. Kutznetsova\",\"doi\":\"10.18705/1607-419x-2022-28-4-419-427\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background. Hypertension (HTN) is a major risk factor for the development of cardiovascular disease in young and middle age, however, data on its effect on cardiovascular risk in older adults are contradictory. Objective. To evaluate the impact of high blood pressure on mortality and the course of major geriatric syndromes in the population aged 65 years and older. Design and methods. The prospective cohort Crystal study (2 examinations, 9 years of follow-up), the cross-sectional cohort Eucalyptus study. Sample: a random sample of community-dwelling older adults aged 65 and older (n = 1007). Main parameters: blood pressure, analysis of drug treatment, medical history, laboratory tests, comprehensive geriatric assessment. Results. HTN has been identified as a risk factor for myocardial infarction, cognitive decline, slow gait speed and low muscle strength. However, in people with frailty and slow gait speed, the presence of HTN was associated with a lower risk of all-cause mortality. The lowest risk of all — cause mortality in participants with a slow gait speed was found with systolic blood pressure 140-159 mm Hg [risk ratio (95 % confidence interval) 0,049 (0,009-0,283)], with frailty — with systolic blood pressure 160-180 mm Hg [risk ratio (95 % confidence interval) = 0,109 (0,016-0,758)]. Conclusions. HTN retains its negative predictive value in older adults and is associated with an increased risk of cardiovascular complications, decreased cognitive and physical functions, but a lower risk of mortality in people with frailty and a low level of physical function. An individual approach and an obligatory assessment of the level of physical function in older patients are required when prescribing antihypertensive therapy.\",\"PeriodicalId\":37695,\"journal\":{\"name\":\"Arterial Hypertension (Russian Federation)\",\"volume\":\"245 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arterial Hypertension (Russian Federation)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.18705/1607-419x-2022-28-4-419-427\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arterial Hypertension (Russian Federation)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18705/1607-419x-2022-28-4-419-427","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
The impact of hypertension on mortality and the risk of developing geriatric syndromes
Background. Hypertension (HTN) is a major risk factor for the development of cardiovascular disease in young and middle age, however, data on its effect on cardiovascular risk in older adults are contradictory. Objective. To evaluate the impact of high blood pressure on mortality and the course of major geriatric syndromes in the population aged 65 years and older. Design and methods. The prospective cohort Crystal study (2 examinations, 9 years of follow-up), the cross-sectional cohort Eucalyptus study. Sample: a random sample of community-dwelling older adults aged 65 and older (n = 1007). Main parameters: blood pressure, analysis of drug treatment, medical history, laboratory tests, comprehensive geriatric assessment. Results. HTN has been identified as a risk factor for myocardial infarction, cognitive decline, slow gait speed and low muscle strength. However, in people with frailty and slow gait speed, the presence of HTN was associated with a lower risk of all-cause mortality. The lowest risk of all — cause mortality in participants with a slow gait speed was found with systolic blood pressure 140-159 mm Hg [risk ratio (95 % confidence interval) 0,049 (0,009-0,283)], with frailty — with systolic blood pressure 160-180 mm Hg [risk ratio (95 % confidence interval) = 0,109 (0,016-0,758)]. Conclusions. HTN retains its negative predictive value in older adults and is associated with an increased risk of cardiovascular complications, decreased cognitive and physical functions, but a lower risk of mortality in people with frailty and a low level of physical function. An individual approach and an obligatory assessment of the level of physical function in older patients are required when prescribing antihypertensive therapy.
期刊介绍:
The main aims of the Journal include collecting and generalizing the knowledge in hypertensiology; education and professional development of cardiologists and medical doctors of other specialties, who deal with different issues regarding diagnostics, management and prevention of hypertension in both clinical practice and research. The Journal also calls attention to the most urgent and up-to-date questions in hypertensiology, cardiology and related sciences. There are additional objectives, such as increasing the availability, accessibility and recognition of Russian medical scientific achievements at the international level by improving the quality of the publication and the way they are presented; enabling the exchange of opinions and information between scientists and their wider communication. The main criteria for publication selection fit with the mentioned objectives and include currency, singularity, scientific and practical novelty, applied relevance etc.