| Objective: With the aging trend of the global population,the prevalence of hypertension combined with frailty is increasing and has seriously affected the quality of life of elderly patients.Blood pressure fluctuation refers to the change of blood pressure level within a certain time,is one of the most basic physiological characteristics of blood pressure.Older people are more likely to have abnormal blood pressure fluctuation than young people,especially abnormal change shows in morning blood pressure and blood pressure variability,these are closely related to the target organ damage,cardiovascular events and the prognosis of elderly hypertensive patients.However,we do not know the relationship between frailty and blood pressure fluctuations.This study is aimed to evaluate the effects of frailty on morning blood pressure and blood pressure variability in elderly hypertensive patients.Methods: A total of 156 elderly patients with hypertension(121males,35females)were divided into control group(non-frail group,n=50),pre-frail group(n=62)and frail group(n=44)according to the results of FRAIL scale.Data on patients' gender,age,history of smoking,hypertension duration and anti-hypertensive drug usage was collected,their blood lipid,fasting blood glucose and blood uric acid were detected.The morning blood pressure and blood pressure variability were evaluated by monitoring the 24-hour ambulatory blood pressure in elderly patients with hypertension.Blood pressure variability was expressed as a percentage of changes in blood pressure.It was calculated including 24 h,daytime and nighttime blood pressure variability.Results: 1.There was no significant difference in gender,age,history of smoking,hypertension duration,anti-hypertensive drug usage,Triglycerides,Total cholesterol,High density lipoprotein cholesterol,Low density lipoprotein cholesterol,Fasting blood glucose and Blood uric acid among the three groups(p>0.05).2.Morning SBP gradually decreased among control group,pre-frail group and frail group(controls,135.5±12.0 mm Hg;pre-frails,130.8±14.3 mm Hg;frails,127.4±10.9 mm Hg;p < 0.01),the difference was statistically significant.Frailty was significantly negative associated with morning SBP by the ordinal regression analysis.However,no significant difference in morning DBP was observed among three groups of elderly hypertensive patients.3.24 h SBP,daytime SBP,nighttime SBP,24 h DBP,daytime DBP,nighttime DBP did not differ among the three groups(p>0.05).4.They gradually increased among control group,pre-frail group,frail group including 24 h SBPV [controls,(10.3±2.6)%;pre-frails,(11.2±2.6)%;frails,(11.8±2.3)%;p <0.05] and daytime SBPV[controls,(10.0±2.7)%;pre-frails,(10.9±2.7)%;frails,(11.3±2.3)%;P < 0.05] by one-way analysis of variance(ANOVA),but frailty was not related to 24 h SBPV or daytime SBPV by the ordinal regression analysis.The nighttime SBPV,24 h DBPV,daytime DBPV,nighttime DBPV did not differ among the three groups(p>0.05).Conclusion: 1.Morning SBP is significantly lower in the elderly frail patients with hypertension,there is negative correlation between frailty and morning SBP.2.Frailty was not related to BPV.Objective: The incidence of the cardiovascular and cerebrovascular diseases keeps growing in elderly hypertensive patients.At the same time the physioloical function also decreases significantly and frailty is common in elderly hypertensive patients.These patients are easily infected virus because of immunologic function obstacles.Previous studies have shown that elderly hypertension is closely related to frailty and virus infection.Human herpesvirus(HHV)and Parvovirus B19(B19V)are the most common pathogen in the population.To explore the relationship between frailty and HHV,B19 V in elderly hypertensive patients,incidence of HHV,B19 V was detected in this study.Methods: A total of 156 elderly patients with hypertension(121males,35females)were divided into control group(non-frail group,n=50),pre-frail group(n=62)and frail group(n=44)according to the results of FRAIL scale.The serum of patients was collected.After viral nucleic acids were extracted from serum,8 herpesvirus and B19 V were detected by Real time PCR.Both Ig M and Ig G of B19 V in serum were detected by ELISA.Results: 1.HSV1,HSV2,VZV,EBV,HCMV,HHV6,HHV7,HHV8 and B19 V were detected in serum of 156 elderly patients.The positive rate of HSV1,HSV2,EBV,VZV,HCMV,HHV6,HHV7,HHV8 and B19 V was 1.3%,1.9%,0.6%,0%,0%,16%(HHV6A 7.7%,HHV6 B 8.3%),0%,1.3% and 11.5% respectively.The positive rate of HHV6 and B19 V was more than others.EBV,HCMV and HHV7 were not found by Real time PCR in this study.2.Viruses were detected in serum of 28 cases of 121 males and in 8 cases of 35 females in elderly hypertensive patients.The positive rate of virus was independent of gender.3.Viruses were detected in serum of 27 cases from 43 with type 2 diabetes and 9 cases from 113 non-diabetic patients in elderly hypertensive patients.The positive rate of virus was significantly correlated with type 2 diabetes.4.The positive rates of HSV1,HSV2,VZV and HHV8 were no significant difference among the three groups(p>0.05).The positive rates of HHV6 A,HHV6B and B19 V were significant difference among the three groups(p<0.01).5.Viruses were detected in 3,8 and 13 cases respectively in control group,pre-frail group and frail group.Coinfection of two viruses was found in 3 and 6 cases respectively in pre-frail group and frail group.Coinfection of three viruses was found in 3 cases of frail group.There were significant differences among the three groups(p<0.05).6.The positive rate of Ig G of B19 V was significant difference among the three groups(p<0.01).The positive rate of Ig M of B19 V was not significant difference among the three groups(p>0.05).Conclusion: 1.HSV1,HSV2,VZV,HHV6 A,HHV6B,HHV8 and B19 V were detected in elderly hypertensive patients.The positive rate of HHV6 and B19 V was the highest among them.The positive rate of viruses was significantly correlated with type 2 diabetes of elderly hypertensive patients.2.Frailty is closely related with infection of both HHV6 and B19 V in elderly hypertensive patients. |
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