| Objective: Hypertension is a major worldwide public health problem,and an important risk factor which leads to cardiovascular and cerebrovasculardisease. With the development of economics and society people's lifeexpectancy have been dramatic improvements, the ratio of the very elderlywith age≥80years old is increased. Hypertension is the most common anddangerous diseases in the very elderly, which leads to serious problems intheir health and quality of life. Therefore the situation that pretreating riskfactors of hypertension will be much severe in older people than in themiddle-aged and young people. The purpose of this study is to through theanalysis of risk factors and condition of blood pressure controlling in veryelderly hypertensive patients with age≥80years old, to explore theprevalence and treatment of elderly hypertensive patients with othercardiovascular risk factor under the condition of present intervention. In orderto guide therapy and precautions.Methods:184(Oct,2007-Dec,2010) cases from the Hebei generalhospital were retrospectively collected from addmitted very elderlyhypertensive patients≥80years of age. SPSS13.0software was adopted torealize the data processing and statistical analysis, the measurement data werepresented by way of expectation±standard deviation, the method ofchi-square test are used to calculate rate compared, and it can be consideredsignificant statistically when p <0.05.Result:1184elderly patients with hypertension were taking part in thissurvey,129of them were male(70.12%) and55were female(29.88%). Stage1Hypertension were10cases(5.43%), Stage2Hypertension were52cases(28.26%), Stage3Hypertension were122cases(66.30%). The course ofhypertension≤10years were80cases(43.48%),the course of hypertension 10-20years were53cases(28.80%),the course of hypertension>20yearswere51cases(27.72%).2There were168elderly hypertensive patients with other cardiovascularrisk factor. Patients with risk factors took91.30%of the total. The descendingorder of the proportion was dyslipidemia, abnormal glucose, uric acidincreased, smoking, alcohol. The proportions of patients with these risk factorswas77.17%,37.50%,15.76%,4.89%and3.80%respectively. The proportionsof male patients with these risk factors was78.29%,38.76%,17.05%,6.98%and5.43%respectively, and proportions of female was74.55%,34.55%,12.73%,1.80%and1.80%respectively. Using chi-square test and p value islarger than0.05, so it can be deduced that there was no statistical differencebetween male and female. Meanwhile, there were78patients with two ormore than two risk factors, took42.39%of the total. The proportion of malepatients with multi-risk factors was much higher than female (p <0.05). Andthere was no statistical difference among very elderly hypertensive patientswith different stage of hypertension and different course ofhypertension(P>0.05).3The number of elderly hypertensive patients with cardio-cerebro-vascular disease was168.The patients with cardio-cerebrovascular diseasetook91.30%of the total. The prevalence of patients with coronary heartdisease, cerebrovascular disease and with both two disease was82.07%,55.43%and44.02%respectively.The different prevalence between male and female elderly hypertensivepatients with cardio-cerebrovascular disease had no statisticallysignificant(P>0.05).The prevalence of stage1with cardio-cerebrovascular disease was lowerthan stage2and3(P<0.05). The prevalence of stage3withcardio-cerebrovascular disease was higher than stage1and2(P<0.05). Theprevalence of stage1hypertension in the very elderly with both twocomplication was lower than stage3(P<0.05).There was neither statisticallydifferent between the prevalence of elderly hypertensive patients with both two complication of stage1and2nor statistically different between stage2and3(P>0.05). The different prevalence of coronary heart disease betweenelderly hypertensive patients with different course had no statisticalsignificance (P>0.05). The different prevalence of cerebrovascular diseasebetween elderly hypertensive patients with different course had statisticalsignificance (P<0.05). The prevalence of cerebrovascular disease of elderlyhypertensive patients with the course>20years and the course10-20yearswas higher than the course≤10years(P<0.05),and there was no statisticalsignificance between the course>20years and the course10-20years(P>0.05).The prevalence of hypertension in the very elderly with bothtwo complication that the course≤10years and the course10-20years werelower than the course>20years(P<0.05), however, no statistical significancewas found between the course≤10years and the course10-20years.4The rate of medicine utilization of elderly hypertensive patients was96.20%.The highest rate of the drug was CCB (66.85%),and the followingwereβ-blocker (57.07%),ARB(45.11%),α-blocker(21.74%), ACEI(14.13%).diuretic(11.41%).As for active treatment, monotherapy consisted of26.55%,combination therapy consisted of73.45%, including two-drug36.72%,three-drug26.55%and four-drug and more10.73%. The most commontwo-drug combination therapy of hypertension in the very elderly wasCCB+β-blocker,and the most common three-drug combination therapy wasARB+CCB+β-blocker.5The rate of medicine utilization and blood pressure control of maleelderly hypertensive patients was95.35%and61.24%, and the female was100%and67.27%.The rate of medicine utilization of patients with stage1,stage2and Stage3hypertension was87.50%,92.45%and99.19%respectively, and the blood pressure control rate was62.50%,66.04%and61.79%respectively. The rates of medicine utilization of patients with thecourse of hypertension (≤10years,10-20years and>20years) was97.50%,92.45%and100%respectively, and the blood pressure control rates was61.25%,62.26%and66.67%respectively. The condition of treatment and control of hypertension in the very elderlywith risk factors (including smoking, alcohol, uric acid increased,dyslipidemia, abnormal glucose) was as follow: The rate of treatment ofpatients with one risk factor was96.67%,and the control rate was67.78%; therate of treatment of patients with two risk factors was96.97%, and the controlrate was63.64%; the rate of treatment of patients with three or more riskfactors was80%, and the control rate was40%.The rates of treatment of patients with coronary heart disease,cerebrovascular disease, and with both of the two disease was97.14%,93.75%and96.30%respectively, and the control rate was68.57%,75.00%and67.90%.The control rates of elderly hypertensive patients using singleanti-hypertensive drug, two-drug,three-drug and four-drug and more was71.74%,60.00%,72.34%and52.63%respectively.Conclusion:1The stage of elderly hypertensive patients was high, stage1hypertension took only5.43%of the total. And their course of hypertensionwas long. The patients with course>10years took56.52%of the total numberof survey.2In very elderly hypertensive patients that collected in this research, theprevalence of dyslipidemia and abnormal glucose was higher, smoking andalcohol were under control. Therefore, the screening of blood glucose, bloodlipid should be noted, so that they could be detected and intervened in time.3In this survey, the rate of male elderly hypertensive patients withmulti-risk factors was higher than female.4The prevalence of elderly hypertensive patients with othercardio-cerebrovascular disease was high (91.30%). The longer the course ofhypertension was, and the higher the stage of hypertension, the higher theprevalence of hypertension in the very elderly with othercardio-cerebrovascular disease was.5The date indicated that the rate of treatment and control was high, the rate was96.20%and66.3%.Rank the drugs according to their using rate,from highest to lowest, the result was CCB, β-blocker (45.11%), α-blocker(21.74%), ACEI, diuretic. Monotherapy took26.55%of the totalnumber of patients who took medicine, combination73.45%.The mostcommon two-drug combination therapy was CCB+β-blocker,and thethree-drug combination therapy was ARB+CCB+β-blocker. At present, theanti-hypertensive drugs utilization in this study complied with the principle ofthe selection of anti-hypertensive drugs. |
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