高血压对死亡率和老年综合征发生风险的影响

A. Turusheva, Y. Kotovskaya, E. Frolova, Т. A. Bogdanova, O. Kutznetsova
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引用次数: 0

摘要

背景。高血压(HTN)是中青年心血管疾病发展的主要危险因素,然而,关于其对老年人心血管风险影响的数据是矛盾的。目标。评估高血压对65岁及以上人群死亡率和主要老年综合征病程的影响。设计和方法。前瞻性队列Crystal研究(2次检查,9年随访),横断面队列Eucalyptus研究。样本:随机抽取居住在社区的65岁及以上老年人(n = 1007)。主要参数:血压、药物治疗分析、病史、实验室检查、老年综合评估。结果。HTN已被确定为心肌梗死、认知能力下降、步态缓慢和肌肉力量低下的危险因素。然而,在身体虚弱和步态缓慢的人群中,HTN的存在与全因死亡率的风险较低有关。步态缓慢的参与者的全因死亡风险最低,收缩压为140-159毫米汞柱[风险比(95%置信区间)0.049(0.009 - 0.0283)],身体虚弱-收缩压为160-180毫米汞柱[风险比(95%置信区间)= 0.0109(0.016 - 0.758)]。结论。HTN在老年人中保持其阴性预测价值,并与心血管并发症风险增加、认知和身体功能下降有关,但在身体虚弱和身体功能水平较低的人群中,死亡风险较低。在处方降压治疗时,需要对老年患者的身体功能水平进行个体方法和强制性评估。
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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.
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来源期刊
Arterial Hypertension (Russian Federation)
Arterial Hypertension (Russian Federation) Medicine-Cardiology and Cardiovascular Medicine
CiteScore
0.90
自引率
0.00%
发文量
38
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.
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