Hypertension In Elderly Research Articles

Effectiveness of Spironolactone in Reducing Osteoporosis and Future Fracture Risk in Middle-Aged and Elderly Hypertensive Patients.

While the role of aldosterone in bone metabolism is well established, the specific effects of the widely used aldosterone antagonist, spironolactone, on bone health are not fully understood. This study aimed to investigate the effects of spironolactone on osteoporosis and future fracture risk in middle-aged and elderly hypertensive patients, revealing its potential benefits for bone health. Propensity score matching was employed in this study to create matched groups of spironolactone users and non-users at a 1:4 ratio. We investigated the association between spironolactone use and the risk of osteoporosis using multivariate logistic regression analysis. Furthermore, we conducted multivariate linear regression analysis to explore the relationship between cumulative dosage and the FRAX score. Subgroup analysis was also performed to assess the effects under different stratification conditions. In both pre-match and post-match analyses, multivariable logistic regression revealed a significant reduction in the risk of osteoporosis in the spironolactone usage group (pre-match: odds ratios [OR] 0.406, 95% confidence interval [CI], 0.280-0.588; post-match: OR 0.385, 95% CI, 0.259-0.571). Furthermore, post-match multivariable linear regression demonstrated a clear negative correlation between cumulative spironolactone dosage and the FRAX score. Subgroup analyses consistently supported these findings. This study offers evidence supporting the significant positive impact of the antihypertensive drug spironolactone on bone health, resulting in a substantial reduction in the risk of osteoporosis and future fractures in hypertensive patients. Future research should consider conducting large-scale, multicenter, randomized controlled trials to further investigate the long-term effects of spironolactone on bone health in hypertensive patients.

Effect of Salt Substitution on Ambulatory Blood Pressure, Kidney Function and Inflammation in Middle-Aged and Elderly Hypertensive Patients.

Low-sodium (LS) salt substitution is recognized for its potential to reduce blood pressure (BP), but most research relies on office BP measurement (OBPM). There is a lack of data on salt substitution's effect on target organs, such as the kidney as measured by the urine albumin-to-creatinine ratio (UACR), and its impact on inflammatory cytokines, particularly high-sensitivity C-reactive protein (hs-CRP). To evaluate the effect of LS salt substitution on ambulatory BP measurement (ABPM), kidney function, and inflammation in middle-aged and elderly hypertensive patients. In this 12-month prospective, multi-center, randomized, double-blind study, 352 hypertensive patients were randomly assigned to the normal salt (NS) group (n = 176) or the LS group (n = 176) at a 1:1 ratio. ABPM, fasting blood, and morning first spot urine samples were obtained at baseline and the endpoint. Of the 352 patients, 322 completed all follow-up surveys, and 301 underwent ABPM. In the LS roup, significant reductions were observed in 24-hr systolic BP (-2.3 mmHg), 24-hr diastolic BP (-1.5 mmHg), daytime systolic BP (-2.6 mmHg), daytime diastolic BP (-1 mmHg), and nighttime systolic BP (-0.1 mmHg) compared to the NS group (all p 0.05). However, the change in nighttime diastolic BP was not statistically significant (-0.3 vs. 1.1 mmHg, p = 0.063). Additionally, the LS group showed a more substantial decrease in UACR (-2.05 vs. -7.40 µg/mg, p = 0.004) and hs-CRP (-0.06 vs. -0.24 mg/L, p = 0.048) compared to NS. LS salt substitution significantly decreased ABPM, suggesting a notable impact on hypertension. Furthermore, it demonstrated a protective impact on kidney function, as evidenced by changes in UACR. Additionally, LS salt substitution appeared to reduce inflammation, indicated by the decrease in hs-CRP levels. The study was registered in the Chinese clinical trial registry (registration number: ChiCTR1800019727).

Self-Efficacy and Quality of Life Among Farmers in Indonesia: A Literature Review

Background: The level of self-efficacy plays a role in influencing the quality of life of hypertension patients. Self-efficacy helps individuals cope with and maintain hypertension health conditions that can affect their quality of life. 55.18% of the total population in Indonesia work in the agricultural sector. Purpose: The aim of this literature review study is to explore the correlation and publications providing information on self-efficacy related to the quality of life of elderly farmers. Methods: This literature review study uses a narrative review approach and analyzes six articles from sources such as Google Scholar, ScienceDirect, and PubMed. Results: The findings suggest a significant association between self-efficacy levels and the quality of life of elderly hypertension patients in Indonesia. Hypertensive elderly farmers with high self-efficacy tend to have a better quality of life. A significant relationship was also found between self-efficacy, subjective well-being in tobacco farmers, and adherence to a healthy lifestyle among hypertension patients. Conclusion: The study concludes that factors such as gender, age, education, and life experience influence self-efficacy. Quality of life is influenced by age, education, gender, marital status, duration of hypertension, and occupation. High levels of self-efficacy are positively correlated with the ability of the elderly to face hypertension challenges and improve their quality of life. Nurses should provide education and motivation to hypertension patients to enhance their self-efficacy.

Analysis of the Effect of Family-Centered Empowerment Model (FCEM) Health Education Through WeChat on Medication Compliance and Blood Pressure of Elderly Hypertensive Patients in Rural Areas

Objective: To validate the effectiveness of a Family-Centered Empowerment Model (FCEM) health education through WeChat on medication compliance and blood pressure among elderly hypertensive patients in rural areas. Methods: One hundred and two rural elderly hypertensive patients aged 65–80 years were selected and randomly divided into an experimental and control group of 51 each. The control group implemented conventional health education, and the experimental group implemented FCEM health education through WeChat platform for 4 consecutive weeks. The Therapeutic Adherence Scale for Hypertensive Patients (TASHP) scores and blood pressure measurements were compared between and within the two groups. Results: After the intervention, there were significant differences in medication compliance and blood pressure between the two groups (P < 0.001). In the control group, before and after the intervention, there was a significant difference in medication compliance (P < 0.001), but no significant difference in blood pressure (P > 0.05). In the experimental group, there were significant differences in medication compliance and blood pressure before and after the intervention (P < 0.001). Conclusion: The FCEM health education through an online social platform significantly improved medication compliance and led to effective blood pressure control in rural elderly hypertensive patients. Therefore, as an effective, safe, and economical model, it is also necessary to explore its effectiveness in improving health problems in other chronic diseases and other age groups.

Health Care Functions of Elderly Families with Hypertension Who Live Alone Life in Bandung District (Phenomenological Study)

Aims: The aim of this research is to explore the health care function of families of elderly people with hypertension who live their lives alone in Bandung Regency. Methods : This research design uses a qualitative method with an exploratory phenomenological approach. The number of participants was 7 people who conducted a focus group discussion (FGD). Results : The results of this research obtained 5 themes, namely recognizing internal and external health problems based on reflex response, making decisions based on personal needs and complaints of the elderly, caring for oneself by preventing and strengthening positive energy, maintaining environmental health through dividing tasks and joint financial responsibility, and increasing optimization utilization of health services. Conclusions : Research on elderly hypertension families reveals five main themes: understanding hypertension through psychological and physical responses, making decisions based on personal needs, self-prevention and positive energy, dividing environmental health and joint financial responsibility, and optimizing health facility use through PKM and Health Services.

Effect of Mat Pilates Training on Blood Pressure, Inflammatory, and Oxidative Profiles in Hypertensive Elderly.

To determine the effects of mat Pilates training on blood pressure, inflammatory, and antioxidative markers in hypertensive elderly people, 34 hypertensive subjects aged 60-75 years were randomly divided into a control group (CON; n = 17) and a mat Pilates training group (MP; n = 17). The CON participants conducted normal daily activities and participated in neither organized exercises nor sports training, while those in the MP group received mat Pilates training for 60 min three times/week for 12 weeks. Parameters including blood pressure, cardiovascular function, nitric oxide (NO), tumor necrotic factor-alpha (TNF-α), superoxide dismutase (SOD), and malonaldehyde (MDA) were collected at baseline and the end of 12 weeks. The MP group had significantly decreased blood pressure, improved cardiovascular variables, decreased MDA and TNF-α, and increased NO and SOD compared with the CON group and the pre-training period (p < 0.05). In conclusion, these findings demonstrate the positive effects of 12 weeks of mat Pilates training in terms of reducing blood pressure and increasing blood flow related to improvements in anti-inflammatory and antioxidative markers in hypertensive elderly people. Mat Pilates training might be integrated as an alternative therapeutic exercise modality in clinical practice for hypertensive elderly individuals.

Effect Of Combination Benson Relaxation Therapy And Lavender Aromatherapy On The Decrease Blood Pressure In The Elderly With Hypertension In Working Area Of Madurejo Health Center Pangkalan Bun Province Central Borneo

Background: Hypertension is a condition where blood pressure exceeds normal limits, namely systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg on repeated examinations. Hypertension, commonly known as high blood pressure, is caused by abnormalities in the blood arteries, preventing oxygen and nutrients from reaching the body's tissues. As an alternative treatment, the combination of Benson relaxation therapy and lavender aromatherapy has similarities in the mechanism of action, as seen in how the Benson relaxation technique works, namely focusing on specific words or sentences that are repeated repeatedly with a regular rhythm accompanied by an attitude of surrender to God Almighty while drawing deep breaths. While lavender aromatherapy works on both the physical and emotional levels, it can also help to lower anxiety, high blood pressure, heart rate, and stress. Lavender also stimulates the production of the hormones melatonin and serotonin. Aromatherapy can be used in a variety of methods, such as steam, inhalation, and compresses. Purpose : the aim of this study was to determine whether there is a combination effect of Benson relaxation therapy and lavender aromatherapy on reducing blood pressure in elderly hypertension at Madurejo Public Health Center in Pangkalan Bun. Methods: This type of quasi-experimental research used a one-group pre-test and post-test design with a sample of 30 respondents and purposive sampling. Blood pressure measurement using a tensimeter and an observation sheet using the Wilcoxon test. Results: The results showed that the blood pressure of hypertension sufferers pre-tested in category 1 was mild at 33.3%, moderate at 56.7%, and severe at 10.0%. The results of the level of type 2 diabetes mellitus post-test were in the good category (83.7%) and sufficient (16.3%). The Wilcoxon test results obtained a p value of 0.000. Conclusion: There is an effect of a combination of Benson relaxation therapy and lavender aromatherapy on reducing blood pressure in elderly hypertension at Madurejo Public Health Center, Pangkalan Bun, Central Kalimantan.

Senam Hipertensi Bagi Lanjut Usia (LANSIA) Di Posyandu Cekke Kabupaten Enrekang

Hypertension exercise is an exercise that aims to increase blood flow and oxygen supply to active muscles and skeleton, especially the heart muscle, so that it can reduce blood pressure. The aim of this community service (PkM) is to increase the understanding of elderly people about hypertension elderly exercise and to determine the effect of elderly hypertension exercise on the blood pressure of elderly people with hypertension in the Posyandu Cekke work area, Enrekang Regency. The method used to achieve the target of this activity is by approaching, lecturing and jointly doing exercises for the elderly with hypertension. The final outcome of this PkM activity is that it can increase the client's knowledge about exercise for the elderly with hypertension and can control complications of hypertension, namely stroke due to hypertension in old age. The method for implementing community service (PkM) is by using counseling which aims to gain knowledge about the importance of exercise for the elderly. It is hoped that after getting the theory about the importance of exercise for the elderly, they will be able to increase their knowledge and be willing to do exercise either at the Posyandu for the Elderly or at home. The result of this community service (PkM) is an increase in the elderly's knowledge about the importance of posyandu, which can be seen from the results of the pre-test and post-test, namely an increase of 32%. Increasing the activeness of elderly people in posyandu and motivation for elderly exercisers to always take part in elderly exercise seriously.

Association between baseline office blood pressure level and the incidence and development of long-term frailty in the community-dwelling very elderly with hypertension.

Frailty is the most important risk factor causing disability in the elderly. Hypertension is one of the most common chronic diseases in the elderly and is closely related to frailty, but there is still controversy about the association between blood pressure and frailty. To explore the association between baseline blood pressure level and the incident and development of long-term frailty in the community-dwelling very elderly (i.e., over 80 years old [1]) with hypertension, in order to provide a basis for scientific blood pressure management of very elderly hypertension. In this study, very elderly hypertensive patients who received comprehensive geriatric assessment from January to June 2019 and with complete data were included, and follow-up was conducted from January 1 to February 14, 2023. A total of 330 very elderly individuals with hypertension were enrolled in this study. FRAIL scale was used to evaluate frailty. Binomial logistic regression analysis was used to calculate the OR and 95%CI between baseline systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) levels and long-term incident and development of frailty. The dose-response relationship between baseline office SBP, DBP or PP levels and incident frailty and its development was analyzed by Generalized Additive Model (GAM) using smooth curve fitting and threshold effect analysis. Smooth curve fitting and threshold effect analysis showed that the relationship between baseline office SBP level and incident frailty was U-shaped, with the nadir of the U-shaped curve at 135 mmHg after adjustment. Baseline office SBP, PP level and development frailty was U-shaped and the nadir was 140 mmHg and 77 mmHg. In the community-dwelling very elderly with hypertension, baseline office SBP level had a relationship with long-term incident frailty and its development and PP level had a relationship with long-term development of frailty.

Geographic disparities of dietary inflammatory index and its association with hypertension in middle-aged and elders in China: results from a nationwide cross-sectional study.

Geographic distribution of dietary inflammatory index (DII) in China has not been thoroughly evaluated and evidence on the association between DII and hypertension among Chinese middle-aged and older population was inadequate. To investigate the geographic disparities of DII and its association with hypertension among Chinese middle-aged and elders. Data was from the China Adults Chronic Diseases and Nutrition Surveillance (CACDNS 2015) for middle-aged and older participants. The DII for each participant was determined through a combination of 3 days 24 h dietary recall interviews and a food frequency questionnaire. Spatial analysis was employed to investigate the geographic distribution of DII in China. Restricted cubic spline models and binary logistic regression analysis were used to assess the relationship between DII and hypertension. The least absolute shrinkage and selection operator (LASSO) regression was applied for identifying key hypertension-related factors, which was then included in the establishment of a risk prediction nomogram model, with the receiver operating characteristic (ROC) curve and decision curve analysis (DCA) being built to evaluate its discriminatory power for hypertension. A total of 52,087 middle-aged and older participants were included in the study, among whom 36.6% had hypertension. it revealed that a clear spatial correlation in the national distribution of DII scores (Moran I: 0.252, p = 0.001), with higher DII scores concentrated in the northwest region and lower DII scores concentrated in the southeast region. Hypertensive participants had higher DII scores compared to those without hypertension (OR: 1.507 vs. 1.447, p = 0.003). Restricted cubic spline models and binary logistic regression analysis demonstrated a positive association between DII and hypertension after adjusting for potential confounding factors. There was a significant increasing trend in the proportion of hypertensive individuals as DII scores increase (p for trend = 0.004). The nomogram model, constructed using key factors identified through LASSO regression, demonstrated a robust discriminative capacity, with an area under the curve (AUC) of 73.2% (95% CI, 72.4-74.0%). Decision curve analysis confirmed the reliability and effectiveness of the nomogram model. Sensitivity analysis conducted within the subpopulation aged under 45 years yielded results consistent with the primary analysis. In Chinese adults middle-aged and older, geographic disparities in dietary inflammatory potential are notable, with lower levels observed in the southeastern coastal regions of China and higher levels in the northwestern regions. Meanwhile, there is a positive association between the inflammatory potential of the diet and hypertension. Additional research is needed to investigate regional disparities in dietary inflammatory potential and pinpoint specific dietary patterns associated with lower inflammation.

Relationship Between Physical Activity and Blood Pressure in Hypertensive Elderly at UPTD Puskesmas Susut I

Introduction: Hypertension is a common problem experienced by some elderly due to several changes in the body's system. This condition is also influenced by several other factors such as decreased activity ability in old age. This study aimed to determine the relationship between physical activity and blood pressure in hypertensives elderly at the Working Area of UPTD Puskesmas Susut I. Method: This study used a correlational analytic design with a cross sectional approach. This study involved 83 samples selected through purposive sampling technique. Data were collected using the Physical Activity Scale for Elderly (PASE) questionnaire and analyzed using the Rank Spearman test. Result: The results showed that the physical activity of the elderly had an average value of 11.43 or categorized as mild physical activity with an average systolic blood pressure was 157 mmHg and diastolic blood pressure was 97 mmHg. There is a relationship between physical activity and blood pressure in hypertensives elderly at the working area of UPTD Puskesmas Susut I (p-value = 0.000). Conclusion: There is a relationship between physical activity and blood pressure in hypertensives elderly. This research can improve nursing services for the elderly with hypertension through providing activities that can increase the physical activity of the elderly

Hypertension among the Elderly in the Tzu Chi Flat, West Jakarta, Indonesia

Aims: Hypertension is a cause of premature death in the world that should be prevented. As well as being the number 3 cause of death after stroke and tuberculosis in Indonesia. This study aims to get an overview of the blood pressure of the elderly in the tzu chi flat so that it can inform especially the elderly, accompanying families, health cadres and health workers so that they can make various efforts to anticipate the occurrence of hypertension, care and rehabilitation measures. Study Design: Cross sectional survey. Place and Duration of Study: Sample in this research is elderly in the Tzu Chi Flat, Jakarta between February – June 2022. Methodology: Quantitative research was used using the survey method with a cross-sectional approach which was conducted on 95 elderly people. This research was divided into 4 phases, namely the preparation phase, the implementation phase, the integration phase and the dissemination. Results: In the implementation, data collection was carried out, namely visual acuity measurements and interviews using a questionnaire where the results obtained were 35 elderly (36.8%) experiencing pre-hypertension. And as many as 38 elderly (40%) experienced hypertension in the age range of 60-74 years. Where 28 (73.7%) elderly hypertension is predominantly not working with (100%) having a low level of education. Conclusion: However, the elderly who have hypertension in the Tzu Chi Flat still have a high level of independence in carrying out their daily activities. Based on these results, it shows that the hypertension rate is strongly related to age, physical activity and level of education in the Tzu Chi flat. For this reason, there must be treatment that can be done, such as prevention and control of hypertension in the elderly, namely early detection which involves the role of the family and even health workers. Health workers can work together with integrated healthcare center cadres as the first line to reach the elderly (An extension of the hand) to increase the knowledge of the elderly about the health status of the elderly.

Description of Family Support for the Elderly Hypertension

One of the most common diseases in the elderly is hypertension. Hypertension, also known as high blood pressure, is a long-term medical condition in which the blood pressure in the arteries is constantly elevated. Lack of adherence and support for hypertension testing is one of the reasons for uncontrolled blood pressure, while family support is the most important factor, especially in terms of health. The purpose of this study was to determine family support for the elderly with hypertension in the elderly Posyandu, Nglaban Hamlet, Nglaban Village, Loceret District. The design of this research a descriptive design, which was conducted on 26th September 2023 at the Posyandu for the elderly in Nglaban Hamlet, Nglaban Village, Loceret District, Nganjuk Regency. The population in this study was 30 hypertensive elderly who attended the Posyandu for the Elderly in Nglaban Hamlet, Nglaban Village, Loceret District, Nganjuk Regency, a sample of 22 respondents taken using the Puprosive sampling technique. The inclusion criteria in this research are hypertensive elderly who live at home with their family. The variable in this study is family support for hypertensive elderly. The instrument used was a questionnaire The results showed that of the 22 respondents, the majority, namely 12 respondents (54.5%), received adequate family support and nearly half, namely 10 respondents (45.5%), received less family support. Family support is needed because it can reduce feelings of anxiety in the elderly, increase enthusiasm for life, involve the elderly in carrying out hypertension treatment so as to obtain the goals of hypertension treatment. So that the family should always provide motivation and support for the elderly with hypertension to make health care efforts and help carry out routine controls in existing health services

Pengaruh Rendam Kaki dengan Air Hangat Campur Kencur terhadap Penurunan Tekanan Darah Lansia Hipertensi Di Desa Pohsanten

&lt;p&gt;&lt;em&gt;Elderly is a phase of someone who experiences increasing age where the group is at risk of experiencing health problems. Hypertension is a condition in which a person experiences an increase in high blood pressure which reaches a systolic number of more than 140 mmHg and a diastolic number of more than 90 mmHg. Several treatments for lowering blood pressure can be carried out, one of which is with non-pharmacological actions. This study aims to determine whether or not there is an effect of soaking feet with warm water mixed with kencur on reducing blood pressure in elderly hypertensives in Pohsanten Village. This study used a quasi-experimental design with a non-equivalent control group before-after design. The population in this study were all hypertensive elderly people in Pohsanten Village. Sampling used a purposive sampling technique with 102 research samples, the experimental group totaling 51 people and the control group totaling 51 people were given the intervention of foot soaks with plain water. The analysis of this study used the Wilcoxon test and the Mann-Whitney test. In this study, the results obtained were p value = 0.000 for systolic blood pressure and diastolic blood pressure with a p value = 0.000, meaning that there was an average difference in systolic and diastolic blood pressure before and after the intervention. It can be concluded that there is an effect of soaking feet in warm water mixed with kencur on reducing blood pressure in elderly hypertensives in Pohsanten Village.&lt;strong&gt;&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;

Retracted: Urine Albumin/Creatinine Ratio and Microvascular Disease in Elderly Hypertensive Patients without Comorbidities.

[This retracts the article DOI: 10.1155/2021/5560135.].

Acute ischemic stroke prediction and predictive factors analysis using hematological indicators in elderly hypertensives post-transient ischemic attack

Elderly hypertensive patients diagnosed with transient ischemic attack (TIA) are at a heightened risk for developing acute ischemic stroke (AIS). This underscores the critical need for effective risk prediction and identification of predictive factors. In our study, we utilized patient data from peripheral blood tests and clinical profiles within hospital information systems. These patients were followed for a three-year period to document incident AIS. Our cohort of 11,056 individuals was randomly divided into training, validation, and testing sets in a 5:2:3 ratio. We developed an XGBoost model, developed using selected indicators, provides an effective and non-invasive method for predicting the risk of AIS in elderly hypertensive patients diagnosed with TIA. Impressively, this model achieved a balanced accuracy of 0.9022, a recall of 0.8688, and a PR-AUC of 0.9315. Notably, our model effectively encapsulates essential data variations involving mixed nonlinear interactions, providing competitive performance against more complex models that incorporate a wider range of variables. Further, we conducted an in-depth analysis of the importance and sensitivity of each selected indicator and their interactions. This research equips clinicians with the necessary tools for more precise identification of high-risk individuals, thereby paving the way for more effective stroke prevention and management strategies.

Correlation analysis of hypertension, traditional Chinese medicine constitution, and LPL gene polymorphism in the elderly in communities in Shanghai.

Research on the genetic mechanisms of hypertension has been a hot topic in the cardiovascular field. To study the correlation between senile hypertension and traditional Chinese medicine (TCM) constitution and lipoprotein lipase (LPL) gene polymorphism and to provide the theoretical basis for TCM prevention and treatment of hypertension. The elderly population in communities in Shanghai (hypertensive: 264 cases; non-hypertensive: 159 cases) was taken as the research object. Essential data and information on TCM constitution were collected. The LPL gene mutation was detected using the second-generation sequencing method. Statistical analysis was performed to clarify the relationship between hypertension and senile hypertension. The correlation of TCM constitution with risk factors and LPL gene polymorphisms was studied. The primary TCM constitutions in the hypertension group were phlegm-dampness constitution (51.52%), yin-deficiency constitution (17.42%), balanced constitution (15.53%), and yin-deficiency (9.43%). Logistic regression analysis showed that the phlegm-dampness constitution (P< 0.05, OR = 2.587) and yin-deficiency constitution (P< 0.01, OR = 2.693) were the risk constitutions of hypertension in the elderly. A total of 37 LPL gene mutation loci (SNP: 22; new discovery: 15) were detected in the LPL gene, and the mutation rates of rs254, rs255, rs3208305, rs316, rs11570891, rs328, rs11570893, and rs13702 were relatively high, which were 26.24%, 26.24%, 16.08%, 14.66%, 13.24%, 12.06%, and 10.64%. In the phlegm-dampness group, the proportion of rs254 CC type, rs255 TT type, and rs13702 TT type in the hypertensive group (77.21%, 77.21%, and 93.38%) was higher than that in the non-hypertensive group (56.41%, 56.41%, and 82.05%), The difference was statistically significant (P< 0.05). The phlegm-dampness constitution and yin-deficiency constitution are the risk factors of hypertension in the elderly; in the phlegm-dampness population, rs254 CC type, rs255 TT type, and rs13702 TT type are the risk factors for elderly hypertension.

Remnant cholesterol and intensive blood pressure control in older patients with hypertension: a post hoc analysis of the STEP randomized trial†.

Emerging evidence shows a close relationship between remnant cholesterol (RC) and hypertension. However, it is unknown whether RC is associated with the effects of intensive systolic blood pressure (SBP) lowering on cardiovascular outcomes. We performed a post hoc analysis of the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial. Participants were randomly allocated to intensive (110 to <130 mmHg) or standard (130 to <150 mmHg) treatment groups. The effects of intensive SBP lowering on the primary composite outcome (stroke, acute coronary syndrome, acute decompensated heart failure, coronary revascularization, atrial fibrillation, or cardiovascular death), the components thereof, and all-cause mortality were analysed by the tertile of baseline RC (lowest, middle, and highest). We followed 8206 patients for 3.33 years (median). The adjusted hazard ratios (HRs) [95% confidence interval (CI)] for the primary outcome were 1.06 (0.73-1.56), 0.58 (0.38-0.87), and 0.67 (0.46-0.96) in the lowest, middle, and highest RC tertiles, respectively (P for interaction = 0.11). However, significant heterogeneity in the treatment effects was observed when comparing the upper two tertiles with the lowest tertile (P for interaction = 0.033). For all-cause mortality, the adjusted HRs (95% CI) were 2.48 (1.30-4.73), 1.37 (0.71-2.65), and 0.42 (0.22-0.80) in the lowest, middle, and highest RC tertiles, respectively (P for interaction <0.0001). Baseline RC concentrations were associated with the effects of intensive SBP lowering on the primary composite cardiovascular outcome and all-cause mortality in hypertensive patients. These results are hypothesis-generating and merit further study. STEP ClinicalTrials.gov number: NCT03015311.

Effects of Ergonomic Exercises on Systolic and Diastolic Blood Pressure of Hypertensive Elderly in Sitopeng Cirebon, Indonesia

Background: Hypertension is a chronic, non-communicable disease that often shows no symptoms but can cause heart failure, stroke, myocardial infarction, atrial fibrillation, and even premature death. The majority of hypertension sufferers in Indonesia are elderly (57.6%). Ergonomic exercise is recommended in the non-pharmacological management of hypertension because it can reduce blood pressure. Aims: To know the effect of ergonomic exercise three times and once per week on systolic and diastolic pressure in hypertensive elderly. Methods: The design is an experiment consisted of two groups before and after intervention; the population is hypertensive elderly in Sitopeng, Cirebon City. The sample sizes were determined by the formula (t-1) (r-1) &gt; 15, where t is the treatment group and r are the replication, so the total sample was 32 hypertensive elderly people who were selected using simple random sampling techniques, and data analysis was carried out using the independent T-test and paired T-test. Results: Ergonomics exercises 3 times per week can reduce systolic pressure in elderly people with hypertension (p = 0.001&lt;0.05), but there was no significant difference between the ergonomic exercise groups 3 times and 1 time per week treatment in systolic (p = 0.520) and diastolic pressure (p = 0.095&gt;0.05). Conclusion: Ergonomic exercise provides good benefits in reducing systole and diastole pressure in elderly people with hypertension. Maximum benefits can be obtained if the elderly perform ergonomic exercise movements perfectly, control medication adherence, and follow a low-salt diet. Recommendation: Give the guidebook to each participant, which they take home and are assisted by family to memorize the movements. Always maintain compliance with taking medication and a low-salt diet.

Effects of Perindopril and Amlodipine Combined with Shengmai Injection in Elderly Hypertensive with Heart Failure

Effects of Perindopril and Amlodipine Combined with Shengmai Injection in Elderly Hypertensive with Heart Failure