ARTERYAL HIPERTENSION AND VERY ELDERLY PATIENTS. THE EXPERIENCE OF AN INTERNAL MEDICINE DEPARTMENT

Abstract

Objective: The purpose of this study is to highlight the clinical and paraclinical characteristics of fragile hypertensive patients, over 85 years old, admitted to a mixed internal medicine department (Covid and non-Covid) between January 2022 and October 2022. Design and method: Between January 2022 and October 2022, 80 patients with a primary or secondary diagnosis of arterial hypertension were admitted, of which only 23 (28.75%) were over 85 years old. Of the 23 patients, 13 (56.52%) were hospitalized with a diagnosis of Sars Cov 2 infection. Regarding the gender distribution, 12 are women (52.17%) and 11 are men (47.82%). Patients comorbidities: 14 patients (60.86%) with different degrees of heart failure, atrial fibrillation (39.13%) - 8 patients and one patient was diagnosed with atrial fibrillation during hospitalization, cognitive disorders and dementia in a proportion of 47.82 % (11 patients) and a significant number of patients were admitted with moderate-severe anemia (13 patients, 56.52%). Of the 9 patients with atrial fibrillation, 5 are male (55%) and 4 (45%) female, cardiac enzymes (troponin and CK MB) are within normal limits in 8 patients. During the medical tests, 3 patients (13.04%) were diagnosed withdifferent of neoplasia. Only 2 patients (8.69%) presented slight dyselectrolytemia (hyponatremia and hypokalemia). Results: Pathologies are treated with: angiotensin converting enzyme inhibitors (17.39% - 4 patients), calcium channel blockers (39.13% - 9), anticoagulants (39.13% - 9 patients), diuretics (26.08 %-6 patients) and beta blockers (11 pac-47.82%). 13 patients (56.52%) died and 43.47% were discharged with an improved condition. 9 patients died as a result of Covid multiple organ system failure, 1 death was of cardiovascular cause and 3 non-Covid pulmonary failure deaths. Conclusions: Frail patients, older than 85 years, with multiple comorbidities, require detailed investigations and adjustments of medication doses according to their status in order to maintain the discreet balance in which they are.