Hypertension In Elderly Research Articles

Abstract 4136180: Sex Differences in Cognition Related to Cerebral Small Vessel Disease Associated with Younger Age ofHypertension Diagnosis

Background: There are sex differences in the effect of age at onset (AO) of hypertension onbrain structural changes later in life. This may differentially affect long-term cognition through cerebral smallvessel disease (CSVD) in females and males. However, whether and how the association between age ofhypertension diagnosis contributes to sex differences in cognitive decline related to CVSD later in life remainsunclear. Objective: Our objective was to examine sex differences in cognition in relation to brain structural changesexacerbated by CSVD caused by younger AO of hypertension. Methods: We used data from the UK Biobank to select participants with a known age of hypertensiondiagnosis who also had neuropsychological test scores for cognitive functions affected by CSVD i.e., memoryand executive function (n= 6095). We stratified data by sex and AO at baseline (2006-2010). Controlparticipants who did not have hypertension were chosen at random using propensity score matching. Principalcomponents analysis (PCA) was used to reduce the number of CSVD related cognitive function tests(measured at 2014 follow-up). We selected participants >65 years of age at the time of cognitive function teststo determine cognitive function later in life. This was followed by a sex disaggregated regression analysis totest for the effect of AO on cognitive functions identified from the PCA in females and males. Results: Our main outcomes were cognitive function tests in the domains of memory (working and visual-spatial) and executive function/processing speed. When compared to normotensive controls, cognitiveoutcomes differed by sex and age of hypertension diagnosis. Whereas females diagnosed at middle age (45-54 years) had worse outcomes in the working memory domain compared to controls, males diagnosed at olderage (>65 years) had worse outcomes compared to controls. Only females diagnosed with hypertension ateither younger age (< 35 years) or older age (>65 years) had worse outcomes in the executive visualdeclarative memory domain. We did not see any differences in the processing speed/executive functiondomain in either males or females. Conclusions: This study demonstrates distinctive characteristics of CSVD-related cognitive decline in malesand females based on the age of hypertension onset. Therefore, CSVD is a critical pathophysiologicalmechanism for sex differences in cognitive decline and may aid in identification of novel sex-specific therapy.

Effect of multimodal opioid-sparing anesthesia on intestinal function and prognosis of elderly patients with hypertension after colorectal cancer surgery

PurposeColorectal cancer (CRC) surgery in elderly patients with hypertension poses challenges due to potential complications and prolonged recovery. This study aimed to assess the impact of multimodal opioid-sparing anesthesia on intestinal function and prognosis of elderly hypertension patients undergoing CRC surgery.MethodsA total of 80 elderly hypertension patients who underwent open surgery for CRC in the People’s Hospital of Xinjiang Uygur Autonomous Region from October 2020 to October 2022 were selected and randomly divided into two group (A and B, n = 40) through the random number table method. Group A received multimodal opioid-sparing anesthesia, defined as low-dose opioid general anesthesia combined with a transversus abdominis plane block, incision infiltration with local anesthetics, and postoperative analgesia via a patient-controlled analgesia (PCA) pump, with the remifentanil dose set at one-third (± 10%) of the conventional group’s dose. Group B received conventional opioid anesthesia, involving standard general anesthesia maintained with remifentanil at 0.4–0.5 µg/(kg·min), incision infiltration with local anesthetics, and postoperative PCA. Primary outcomes included mean arterial pressure (MAP) and heart rate (HR), changes in albumin, C-reactive protein (CRP) and white blood cell (WBC), indicators of intestinal function recovery (the recovery time of bowel sounds, the first exhaust time, the first defecation time and the feeding recovery time), and visual analogue scale (VAS) pain scores. Second outcomes included postoperative complications and total hospital stays.ResultsAfter excluding 8 patients, 72 were included in the final analysis. Compared with patients in the B group, patients in the A group exhibited shorter recovery time of bowel sounds, first exhaust time and feeding recovery time (P < 0.05), higher levels of postoperative albumin, and lower levels of CRP and WBC (P < 0.05). Moreover, the incidence of nausea and vomiting was lower and the total hospital stays were fewer in the A group than in the B group (P < 0.05).ConclusionMultimodal opioid-sparing anesthesia contributes to rapid recovery of postoperative intestinal function and reduction of postoperative adverse reactions. Therefore, it is safe and feasible to apply multimodal opioid-sparing anesthesia to elderly hypertension patients receiving open surgery for CRC.

Association between renal function impairment and body roundness index (BRI) in elderly hypertensive patients

Abstract Objective The purpose of this study was to explore the associations of renal function impairment and body roundness index (BRI) in elderly hypertensive patients. Methods This is a community-based observational and cross-sectional study.A total of 1482 elderly hypertensive patients from our center in 2021 were enrolled. Waist-to-hip ratio(WHR) , Body mass index(BMI) and BRI were calculated with validated formulas. According to tri quantile method of BRI level , the patients were divided into low , medium and high BRI groups. The incidence of renal function impairment in the three groups was compared to explore the associations of renal function impairment and BRI in elderly hypertensive patients. Result According to the estimated glomerular filtration rate (eGFR) level, the patients were divided into two groups: impaired renal function group and non impaired renal function group. 133 cases were included in the group with impaired renal function, and 1349 cases were included in the group without impaired renal function. The proportion of patients with impaired renal function was 8%, 497 were in the low BRI group, 491 in the medium BRI group, and 494 in the high BRI group. Comparing the incidence of renal function impairment in patients with different BRI levels, the results showed that the incidence of renal function impairment in patients with high BRI was higher than that in patients with low BRI (7.0%vs.11.5%,p=0.015). The results of binary logistic regression analysis showed that the risk of renal function impairment increased by 19% for each unit of BRI increase (95%CI 1.037-1.122,P=0.024). After adjusting for age, gender, blood lipid, smoking and drinking history, years of hypertension, diabetes, years of diabetes,and random blood glucose levels, the risk of renal function impairment in high BRI group was still significantly higher than low BRI group (OR=1.697,95%CI 1.031-2.794,P=0.038),shows that BRI is an independent risk factor for renal function impairment in elderly hypertension patients. The receiver operating characteristic curve (ROC) results show that the prediction ability of BRI in the whole population is better than that of BMI and waist circumference (WC), and the prediction ability of BRI in elderly female population is the best (AUC=0.569). Conclusion Increasing of BRI is correlated with the occurrence of renal function impairment in elderly hypertension patients, and has the best predictive value for renal function impairment in elderly women with hypertension.

O97 RESPONSE TO AEROBIC TRAINING MAY DIFFER BETWEEN ELDERLY MEN AND WOMEN WITH TREATED HYPERTENSION

Background and objective. Hypertension incidence increases with aging, with expressive enhancement in women after the menopause due to the important physiological changes induced by the estrogen levels decline. Aerobic training is recommended for lowering blood pressure (BP) in men and women with hypertension. However, the possible gender-related differences in training responses have been poorly investigated, especially in elderly patients. Therefore, the objective of this study was to analyze responses to aerobic training in elderly men and women with treated hypertension. Methods: Thirty-one elderly hypertensives (15 women, 68±6ys and 16 men, 66±7ys) who were taking regular antihypertensive medication for at least 4 months participated in the study. They underwent 10 weeks of an aerobic training designed in accordance with the guidelines’ recommendations for hypertension (i.e. 3 session/week, cycle ergometer, 30-45 min, moderate intensity). Before and after the training period, peak oxygen uptake (VO2peak, cardiopulmonary exercise test), BP (auscultatory), systemic hemodynamics (CO2 rebreathing technique) and vascular function (brachial doppler ultrasound) were assessed. In each group (men and women), the training effects were evaluated using paired t-tests or Wilcoxon tests, considering p&lt;0.05 as significant. Results: Aerobic training increased aerobic capacity in both sexes (men = 20.8±4.2 vs. 21.8±4.8 ml.kg-1.min-1, p=0.04 and women = 15.3±2.6 vs. 16.4±2.3 ml.kg-1.min-1, p=0.01). In men, systolic BP and systemic vascular resistance decreased (129±13 vs. 125±12 mmHg, p=0.003 and 21.0±3.8 vs. 18.9±4.1 u, p=0.02), while flow mediated dilation increased (5.5±2.9 vs. 7.2±3.1%, p=0.01) after the training period. On the other hand, in women, none of these variables changed with the training (124±15 vs. 126±12 mmHg, p=0.92; 23.2±5.5 vs. 23.5±5.6 u, p=0.80; and 4.2±3.2 vs. 5.4±3.5%, p=0.10). The other variables assessed did not change in either group. Conclusions: The proposed aerobic training program increased aerobic capacity in both male and female elderly hypertensives, but improved BP, systemic vascular resistance, and endothelial function only in males. Key-words: aerobic training, gender, blood pressure, hypertension. Financial Support: CAPES-0001, CNPq-302309/2022-5, and FAPESP- 2022/12605-3.

Abstract P348: Effects of Different Antihypertensive Regimens on Cognitive Function and Blood Pressure Changes in Elderly Hypertensive Patients: Network Meta-Analysis

Background: Elderly hypertensive patients with cognitive impairment not only exhibit reduced processing speed and executive function but also suffer significant deficits in memory and motor speed, adversely affecting their quality of life. This study employs a network meta-analysis to evaluate the effects of different antihypertensive regimens on cognitive function and blood pressure changes in elderly hypertensive patients. Methods: A comprehensive search was conducted in PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang and VIP databases for randomized controlled trials on different antihypertensive regimens for elderly hypertensive patients. Data analysis and graphing were performed using Review Manager 5.3 and Stata 16.0 software. Results: A total of 16 studies involving 11,694 elderly hypertensive patients and six antihypertensive regimens were included. The network meta-analysis results indicated that elderly hypertensive patients treated with angiotensin II receptor blockers (ARBs) had a greater change in cognitive function scores compared to those receiving usual care (standardized mean difference [SMD] = 0.46, 95% CI [0.23, 0.70]), angiotensin-converting enzyme inhibitors (ACEIs) (SMD = 0.33, 95% CI [0.06, 0.61]), beta-blockers (BBs) (SMD = 0.48, 95% CI [0.17, 0.78]), and diuretics (SMD = 0.32, 95% CI [0.01, 0.63]). Similarly, patients treated with calcium channel blockers (CCBs) showed greater changes in cognitive function scores compared to those receiving usual care (SMD = 0.37, 95% CI [0.04, 0.70]) and BBs (SMD = 0.38, 95% CI [0.02, 0.74]). The SUCRA rankings for changes in cognitive function scores among different antihypertensive regimens were ARB (93.6%), CCB (81.2%), diuretics (47.1%), ACEI (43.4%), usual care (17.9%), and BB (16.8%). Conclusion: The current evidence suggests that, compared to usual care, ACEIs, BBs, CCBs, and diuretics, ARBs might be the optimal regimen for improving cognitive function in elderly hypertensive patients.

Pengaruh Edukasi terhadap Dukungan Keluarga dalam Pengelolaan Hipertensi pada Lansia di UPTD Puskesmas Jekan Raya, Palangka Raya

Education is an independent nursing intervention designed to help individuals, groups, or communities, including hypertension patients, address their health issues through learning activities, with nurses acting as educators. Hypertension is a chronic disease often referred to as the "silent killer." Family support is crucial for hypertension patients in dealing with problems that arise during long-term treatment. Based on interviews with 10 elderly hypertension patients, it was found that when they went for health check-ups and monitoring at healthcare facilities, they were not accompanied by their families. This study aims to analyze the Effect of Education on Family Support in Hypertension Management for the Elderly at UPTD Jekan Raya Health Center, Palangka Raya. Method: This study used a Pre-Experimental Design with a One-Group Pretest-Posttest approach. The sampling technique was Purposive Sampling, with 49 respondents. Results: Based on the results of the Paired Sample Test, a p-value of 0.00 was obtained, which indicates a significance level of p &lt; 0.05. Therefore, it can be concluded that the alternative hypothesis (Ha) is accepted, meaning that education significantly influences family support in managing hypertension in the elderly at UPTD Jekan Raya Health Center, Palangka Raya. Conclusion: There is a significant effect of education on family support in managing hypertension for the elderly at UPTD Jekan Raya Health Center, Palangka Raya.

Compliance to Medication Management and Mental Health Status of Elderly Hypertensive Patients: Basis of Educational Health Program

Objective: The study aimed to assess medication management compliance and mental health in elderly patients with hypertension. Method: The study evaluated medication compliance and mental health status of elderly hypertensive patients in China using simple random sampling. Data was collected using the Morisky Medication Compliance Questionnaire, Hospital Anxiety and Depression Scale, and a checklist. Ethical practices were strictly observed. Results: A study of 100 elderly hypertensive patients found poor drug management compliance, with female patients showing worse compliance. Female patients were more vulnerable to anxiety and depression. The study also found no significant association between gender, age, education level, marital status, living standards, and medication compliance. Barriers to medication management included food and daily necessities, lack of awareness about the importance of drug treatment, and basic family needs. The lowest-ranked barriers were lack of support from government health clinics, low income, and lack of family support. Conclusion: Based on the results, the study proposes an educational plan for elderly hypertensive patients and their families, to be evaluated and implemented by the hospital and township community service center. The plan aims to improve medication management and lifestyle modification compliance, encourage active participation, and provide access to medical and mental health clinics, support groups, and counseling services.

Pengaruh Pemberian Rebusan Jahe terhadap Penurunan Tekanan Darah pada Lansia Hipertensi di Wijaya Kusuma, Jakarta Barat

This study aims to determine the effect of giving ginger decoction to reducing blood pressure in elderly hypertensives. This study used a quasi-experimental design with a pre-post test without control group design. The population in this study were elderly people who suffer from hypertension in RT 07 Wijaya Kusuma, West Jakarta. The number of samples in this study were 22 people using the total sampling technique. The instruments in this study were 4gr ginger, 200cc water, digital scales, honey, knife, measuring cup, and digital tensimeter (automatic). The research results showed that the average systolic blood pressure at the first measurement (pre test) was 141.32 mmHg with a standard deviation of 10.242. In the last measurement (Post Test) the average systolic blood pressure was 132.59 mmHg with a standard deviation of 3.912 while the average diastolic blood pressure in the first measurement (Pre Test) was 94.27 mmHg with a standard deviation of 10.416 and in the last measurement (Post Test) was 81.55 mmHg with a standard deviation of 7.614. Statistical analysis using the paired t-test showed p value = 0.001 so it can be concluded that there is an effect of giving ginger decoction to reducing blood pressure in elderly hypertensives. Based on the results of the study, nurses are expected to be able to provide interventions to address hypertension problems by administering ginger decoction which can lower blood pressure on an ongoing basis without significant side effects and can be used as traditional medicine in patients with hypertension.

Evaluating potential unexpected adverse events and mortality after oral analgesics administration in fracture care-A cohort study.

Analgesic selection per individual's tolerance is essential to avoid risks. The study evaluated current oral analgesic prescription practice, analgesic adverse effects-related factors, unexpected events, and mortality post-fracture surgery. Present prospective cohort study from June 2022 to July 2023 enrolled a total of 198 proximal femoral, ankle, and hindfoot trauma fracture patients. Stratification was done for oral analgesics prescribed at hospital discharge and 1 week with their accompanying toxicity assessed for 2 weeks. Analyzed Kaplan-Meier curve and the absolute risk for possible analgesics-related deaths. Following oral analgesics administration, 122 (62%) patients experienced adverse events. In seven expiries, five were possibly due to acetaminophen added tramadol combined with any of pregabalin, diclofenac, etoricoxib, or gabapentin (absolute risk 2.5%, 97.5% proportion 2 weeks survival). Three (2% of 122) patients taking acetaminophen added tramadol or diclofenac experienced unexpected serious adverse events. Elderly diabetic and hypertensive hip fracture patients expired or experienced unexpected events. Data suggest that oral acetaminophen added tramadol combined with any of pregabalin, diclofenac, etoricoxib, or gabapentin might increase the death risk or unexpected serious adverse events in elderly diabetic and hypertensives suffering from intertrochanteric/femoral neck fracture. Safe analgesic selection is necessitated for at-risk patients.

The Effects of Functional Training on the Ambulatory Blood Pressure and Physical Fitness of Resistant Hypertensive Elderly People: A Randomized Clinical Rehearsal with Preliminary Results.

This study evaluated the impact of functional training (FT) on the ambulatory blood pressure and physical fitness of resistant hypertensive older adults. This randomized clinical and controlled rehearsal involved 15 participants from Juazeiro do Norte-CE divided into two groups: a control group (CG), n = 7, without physical training, and an experimental group (EG), n = 8, subjected to 24 sessions of FT. The comparative analysis included ambulatory blood pressure (24 h mapping) and physical fitness (Senior Fitness Test), using an ANOVA of two factors, an alpha of 0.05, and a post hoc by Bonferroni where necessary. The dimension of the intervention effect was verified using Eta Squared. The results show that FT promoted a significant reduction in systolic blood pressure (SAP) during the day and at night, as well as improving physical fitness, including the force/resistance of the lower and upper limbs, physical mobility, and aerobic resistance. The flexibility of the upper and lower limbs was not affected. It is concluded that FT is effective in reducing SAP and improving physical fitness in resistant older adults. However, this type of training may positively influence general physical fitness of older adults with resistant hypertension.

THE CORRELATION OF LEVEL KNOWLEDGE AND ELDERLY HYPERTENSION DIET ADHERENCE IN NGANJUK REGENCY

Hypertension or high blood pressure is one of the non-communicable diseases caused by lifestyle. One prevention so that complications do not occur is to change lifestyle, food intake and routine blood pressure control. The purpose of this study was to determine the correlation of level knowledge and elderly hypertension diet adherence in Nganjuk Regency This research design used was correlative with a cross-sectional approach. The population was 28 hypertension elderly people who actively participated in the elderly Posyandu of Cepoko Village the sample all of 28 people as taken by total sampling. The independent variable is the level of knowledge in hypertension, the dependent variable was Elderly Hypertension Diet Adherence. Data collection was carried out using questionnaires. The data was analysed by Spearmen Rank Correlation test with an alpha of 0.05. The results of the study found that 67.86% of respondents including compliant and 32.14% non- adherence, following the hypertension diet and the results of the calculation of SPSS 25 significance value of 0.000, meaning was Ho rejected. The conclusion of this study was there are The Correlation of Level Knowledge and Elderly Hypertension diet adherence In Nganjuk Regency For this reason, it is hoped that the increasing role of families, cadres and nurses providing health education through interesting information such as using audiovisual such as social media content will be very capable of influencing knowledge that ultimately changes behaviour and compliance with something. Keywordslevel of knowledge, diet adherence, elderly hypertension

Mediation Effect of Obesity on the Association of Socioeconomic Status with Blood Pressure in the Elderly Hypertensive Population.

Socioeconomic status (SES) plays a crucial role in blood pressure (BP) control. SES may influence BP control through obesity indices, such as body mass index (BMI) and waist circumference (WC). This study aimed to understand the relationships between SES and BP control in the elderly hypertensive population, and to determine whether BMI and WC mediate the relationship between SES and BP control. The study was conducted in Jia County, Henan Province, China, from 1 July to 31 August 2023. The 18,963 hypertensive people over 65 years old who were included in the National Basic Public Health Service Program were investigated. The study utilized questionnaire surveys to collect data on participants' demographic characteristics, disease history, lifestyle behaviors, antihypertensive medication, and measured height, weight, and blood pressure. SES was indexed by participants' self-reported educational level, family income, and occupation, and categorized into low, medium, and high groups by using latent category analysis (LCA). Logistic regression models were used to analyze the associations between SES and BP control. Obesity indicators, represented by BMI and WC, were included in mediation models to examine the indirect effects of BMI/WC on the association between SES and BP control. The mean age of 17,234 participants was 73.4 years and 9888 (57.4%) of the participants were female. The LCA results indicated the number of participants in low SES, middle SES, and high SES groups were 7760, 8347, and 1127, respectively. Compared with the low SES group, the odds ratios (ORs) and 95% confidence intervals (CIs) for the association of BP control with middle SES and high SES were 1.101 (1.031, 1.175), and 1.492 (1.312, 1.696). This association was similarly found in the subsequent subgroup analyses (p < 0.05). Compared with low SES, our findings further suggested that BMI (indirect effects: 95% CIs: -0.004--0.001; p < 0.001) and WC (indirect effects: 95% CIs: -0.003--0.001; p = 0.020) play a suppressing role in the association between high SES and BP control. Our study indicated that the elderly hypertensive population with high SES may have a better result for BP control. However, we found that BMI/WC plays a suppressing role in this association. This indicated that despite the better BP control observed in elderly hypertensive populations with high SES, BMI and WC might undermine this beneficial relationship. Therefore, implementing strategies for obesity prevention is an efficient way to maintain this beneficial association between high SES and BP control.

The association between serum folate and elderly diastolic hypertension: results from the NHANES (2007–2018)

Aim To explore the association between serum folate concentration and the prevalence of elderly diastolic hypertension. This study aims to identify potential relationships that could inform further research into the mechanisms underlying hypertension management. Methods Data from six NHANES cycles (2007–2008, 2009–2010, 2011–2012, 2013–2014, 2015–2016, and 2017–2018) were analysed for individuals aged over 60. Weighted logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and restricted cubic spline (RCS) regression explored the serum folate concentration and elderly diastolic hypertension relationship. Results This study included 9,419 participants (4,734 females and 4,685 males) with a mean age of 70.0 ± 7.0 years. Among them, 360 were diagnosed with diastolic hypertension. In the fully adjusted model, there was a negative correlation between serum folate concentration and the prevalence of diastolic hypertension (OR 0.65; 95% CI: 0.52–0.82). When serum folate concentration levels were divided into quartiles (in μg/dL), the ORs for diastolic hypertension corresponding to Q2 (1.29–1.98), Q3 (1.99–3.08), and Q4 (3.09–5.56) levels compared to Q1 (0.18–1.28) were 1.41 (95% CI: 0.60–3.33), 0.48(95% CI: 0.20–1.16), and 0.35 (95% CI: 0.16–0.74), respectively, with a P for trend <.05. Restricted cubic spline plots showed a negative correlation between serum folate concentration and the prevalence of diastolic hypertension (non-linearity: p = .495). Subgroup analysis indicated that the negative correlation between serum folate concentration and the prevalence of diastolic hypertension was more significant in female participants (interaction p = .009). Conclusion Higher serum folate concentration is associated with a lower prevalence of diastolic hypertension in the elderly.

Impact of Hypertension Duration on the Cardiovascular Benefit of Intensive Blood Pressure Control.

The optimal timing for initiating intensive systolic blood pressure (SBP) treatment remains unclear. While longer hypertension duration is positively associated with increased cardiovascular disease risk, it is unknown whether patients with prolonged hypertension can derive similar benefits from intensive SBP treatment. From the STEP trial (Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients), 8442 participants with complete hypertension duration data were categorized by hypertension duration ≤5 years, 5 to 10 years, 10 to 15 years, and >15 years. The primary outcome was a composite of cardiovascular events. Hazard ratios were calculated using the Fine-Gray subdistribution hazard model. The incidences of the primary outcome increased significantly in patients with hypertension over 15 years than those <5 years in the standard SBP treatment group (adjusted hazard ratios, 1.68 [95% CI, 1.11-2.56]) but not in the intensive treatment group. Each 1-year increase in hypertension duration continuously increased the adjusted risk of major cardiovascular events by 4% (95% CI, 1.01-1.08) up to 20 years, plateauing at an adjusted hazard ratio of 2.27 (95% CI, 1.28-4.04). After intensive SBP treatment, the incidences of major cardiovascular events were similar across different hypertension duration groups, which were 2.22%, 1.69%, 3.02%, and 2.52%, respectively (P>0.05). Subgroup analyses indicated a potential sex difference in this relationship between hypertension duration and the primary outcome in the standard SBP treatment group (Pinteraction=0.05). Initiating intensive SBP treatment at any stage of hypertension duration could reduce cardiovascular disease risk to a comparable level. URL: https://www.clinicaltrials.gov; Unique identifier: NCT03015311.

Influence of multiple risk factor control level on cardiovascular outcomes in hypertensive patients.

The relationship between the level of baseline risk factor control and cardiovascular outcomes in hypertensive patients with blood pressure intervention is not well understood. It is also unclear whether the level of baseline risk factor control is persuasively associated with cardiovascular outcomes in hypertensive patients with blood pressure lowering strategy. We performed an analysis of the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial. Participants without complete baseline risk factor data were excluded. The primary outcome was a composite of cardiovascular events and all-cause mortality. Cox proportional hazard models were used to calculate the hazard ratio (HR) and estimate association between risk factor control levels (≥6, 5, 4, and≤3) and cardiovascular outcomes. A total of 8337 participants were involved in the analysis and the median follow-up period was 3.19 years. Each additional risk factor uncontrolled was associated with a 24% higher cardiovascular risk (HR 1.24, 95% CI 1.11-1.37). Compared with participants with optimal risk factor control, those with≤3 factors control exhibited 95% higher cardiovascular risk (HR 1.95, 95% CI 1.37-2.77). The corresponding protective effects of multiple risk factor modification were not influenced by intensive or standard antihypertensive treatment (P for interaction=0.71). A stepwise association was observed between cardiovascular risk and the number of risk factor control in hypertensive patients. The more risk factor was modified, the less cardiovascular risk was observed, irrespective of different blood pressure lowering strategies. Comprehensive risk factor control strategies are warranted to reduce cardiovascular disease risk in hypertensive patients. Trial registration STEP ClinicalTrials.gov number, NCT03015311. Registered 2 January 2017.

The Effect of Preventive Care and Rehabilitation Nursing on Elderly Hypertension

Objective: To improve the effectiveness of elderly hypertension care, this research applied preventive care and rehabilitation nursing in clinical nursing to clarify their impact on elderly hypertension. Methods: A total of 95 elderly hypertensive patients who received diagnosis and treatment in the hospital during the period of January 2023 to December 2023 were analyzed. They were divided into a control group (49 cases) and an observation group (46 cases) in order of diagnosis and treatment. The patients in the control group were implemented conventional care methods, and the patients in the observation group using preventive care and rehabilitation nursing, the intervention effect between the two groups were analyzed. Results: Compared with the control group, in terms of clinical indicators and blood pressure and blood lipids, the observation group had lower values (P&lt;0.05). In terms of healthy behavior, the observation group had higher values (P&lt;0.05). Conclusion: Implementing preventive care and rehabilitation nursing in clinical nursing can have a positive impact on elderly patients with hypertension, which is beneficial for stabilizing clinical indicators, blood pressure indicators, blood lipid indicators, thus improving patients’ health behavior.

A Meta-analysis of Intensive and Standard Antihypertensive Safety in Elderly Hypertensive Patients

Objective: To evaluate the effect of intensive and standard antihypertensive pressure on cardiovascular and cerebrovascular events, serious adverse events and all-cause deaths in elderly hypertensive patients. Methods: Pubmed, Embase, Cochrane, CNKI, Wanfang and CBM databases were searched. All of the included studies were the RCT trials. Relative risk (RR) and 95% confidence interval (95%CI) were used to evaluate differences in enhanced and standard antihypertensive outcomes. Statistical analysis was applied using the Stata 17.0 software. Results: Seven tests were retrieved to meet the conditions, Different antihypertensive effects showed overall statistical differences in the incidence of cardiovascular and cerebrovascular events, Significant decrease in the intensive antihypertensive group [P=0.000, RR95%CI:0.79(0.69-0.90)], Among them, the incidence of acute myocardial infarction (AMI) and acute coronary syndrome (ACS) was significantly reduced in the intensive antihypertensive group [P=0.000, RR95%CI:0.62(0.48-0.81)], The incidence of stroke events was significantly fewer in the intensive group [P=0.000, RR95%CI:0.62(0.48-0.81)]; There was no significant difference in the incidence of acute HF (AHF) between the two groups [P=0.242, RR95%CI:0.55(0.20-1.50)]. There was no significant statistical difference in the incidence of serious adverse events overall by different antihypertensive criteria [P=0.251,RR95%CI:1.12(0.92-1.36)], of which two groups were eGFR&lt;30ml/min/1.73m2There was no significant statistical difference in the incidence [P=0.280,RR95%CI:1.46(0.74-2.89)], no significant statistical difference in the incidence of orthostatic hypotension [P=0.473,RR95%CI:1.47(0.51-4.23)], no significant statistical difference in the incidence of falls [P=0.607,RR95%CI:1.24(0.54-42.86)], and the incidence of syncope in the intensive antihypertensive group was higher than that in the standard antihypertensive group [P=0.009,RR95%CI:2.43(1.24-4.77)]. There was no significant statistical difference in the effect of different antihypertensive criteria on all-cause death [P=0.156,RR95%CI:0.92(0.81-1.03)]. Conclusion: Compared with the standard antihypertensive in elderly patients with hypertension, there is no significant statistical difference in the incidence of serious adverse events and all-cause mortality in the elderly, and the incidence of cardiovascular and cerebrovascular events in the elderly.

Comparable cerebral cortex activity and gait performance in elderly hypertensive and healthy individuals during dual-task walking: A fNIRS study.

Hypertension increases the risk of cognitive impairment and related dementia, causing impaired executive function and unusual gait parameters. However, the mechanism of neural function illustrating this is unclear. Our research aimed to explore the differences of cerebral cortex activation, gait parameters, and working memory performance between healthy older adults (HA) and older hypertensive (HT) patients when performing cognitive and walking tasks. A total of 36 subjects, including 12 healthy older adults and 24 older hypertensive patients were asked to perform series conditions including single cognitive task (SC), single walking task (SW), and dual-task (DT), wearing functional near-infrared spectroscopy (fNIRS) equipment and Intelligent Device for Energy Expenditure and Activity equipment to record cortical hemodynamic reactions and various gait parameters. The left somatosensory cortex (L-S1) and bilateral supplementary motor area (SMA) showed higher cortical activation (p<.05) than HA when HT performed DT. The intragroup comparison showed that HT had higher cortical activation (p<.05) when performing DT as SW. The cognitive performance of HT was significantly worse (p<.05) than HA when executing SC. The activation of the L-S1, L-M1, and bilateral SMA in HT were significantly higher during SW (p<.05). Hypertension can lead to cognitive impairment in the elderly, including executive function and walking function decline. As a result of these functional declines, elderly patients with hypertension are unable to efficiently allocate brain resources to support more difficult cognitive interference tasks and need to meet more complex task demands by activating more brain regions.

Factors associated with Uncontrolled Hypertension among the elderly hypertension in Rural Region of Vietnam

Factors associated with Uncontrolled Hypertension among the elderly hypertension in Rural Region of Vietnam

Awareness: the Golden Key to Understanding Healthcare Seeking Behavior among Elderly Hypertensive Patients in Taft, Iran

Introduction: Healthcare seeking behavior is crucial for early detection and proper management of hypertension in the elderly. This study investigated the factors influencing healthcare seeking behavior among elderly hypertensive patients residing in Taft, Iran. Methods: This cross-sectional study recruited 230 hypertensive individuals aged 60 and above residing in Taft, Yazd Province, Iran. Participants were randomly selected and completed a questionnaire through face-to-face interviews. The questionnaire assessed their healthcare seeking behaviors and potential influencing factors. Data analysis was performed using SPSS software. Correlation tests and linear regression analysis were employed to identify significant relationships (p &lt; 0.05). Results: A significant majority (70%) of participants reported always paying attention to symptoms of high blood pressure. When experiencing symptoms, over half (53.9%) of the participants indicated a preference for visiting health centers, general practitioners' offices, or emergency departments. Among the factors studied, awareness (B = 0.228) emerged as the most significant positive predictor of healthcare seeking behavior (p &lt; 0.05). Other positive influences included decision-making autonomy (B = 0.177), prior experience with healthcare services (B = 0.131), and social support (B = 0.131) – all statistically significant at p &lt; 0.05. Conversely, barriers to healthcare seeking had a negative and significant impact (B = - 0.064, p &lt; 0.05). Collectively, the investigated factors explained 23% of the variation observed in healthcare seeking behavior among the elderly participants (R2 = 0.23). Conclusion: This study identified awareness of hypertension as the strongest predictor of healthcare seeking behavior in elderly patients. Additionally, providing accessible and supportive healthcare services can further encourage elderly hypertensive patients to seek necessary care.