Relationship Between Blood Pressure And Related Factors In Elderly Patients With Hypertension

ObjectivesThe aim of this study was to analyze elderly hypertensive patients with cardiovascular risk factors, target organ damages and clinical diseases. Compared different stratifying of age and blood pressure(BP) level of target organ damages and clinical diseases in elderly hypertension patients. MethodsFrom January 2007 to December 2009, 1593 hypertensive patients of 60 years old and above were collected in department of geriatrics of Fujian Provincial Hospital. The differences between groups were evaluated by independent sample t test and chi square test. Using single factor analysis of variance for trend test. Two classification logistic regression analysis of cardiovascular risk factors, target organ damages and clinical diseases in elderly patients with hypertension. Results1. In elderly hypertensive patients with cardiovascular risk factors: the number of smoking was 251, accounting for 15.8%; the number of obesity was 159, accounting for 10.0%; the number of dyslipidemia was 787, accounting for 49.4%; the number of fasting glucose impaired was 13, accounted for 0.8%; the number of glucose tolerance abnormal was 178, accounted for 11.2%; the number of family history of cardiovascular disease was 436, accounted for 27.4%. In elderly hypertensive patients with target organ damages: the number of left ventricular hypertrophy was 231, accounting for 14.5%; the number of carotid atherosclerosis was 237, accounting for 14.9%; the number of eGFR decreased was 249, accounting for 15.6%; the number of microalbumin urine was 112, accounting for 7.0%. In elderly hypertensive patients with clinical disorders: in terms of cerebral vascular disease, the number of cerebral hemorrhage was 16, accounting for 1.0%; the number of ischemic stroke was 99, accounting for 6.2%; the number of transient ischemic attack was 33, accounting for 2.1%. In terms of cardiovascular diseases, the number of coronary heart disease was 715, accounting for 44.9%; the number of chronic heart failure was 1155, accounting for 72.5%. In peripheral vascular diseases, the number of lower extremity arteriosclerosis was 102, accounting for 6.4%; the number of diabetes was 502, accounting for 31.5%.2. Divided elderly hypertensive patients in 60~ 69 years group, 70~ 79 years group, and ?80 years group, the proportion of eGFR decreased was 7.1%, 19.4% and 24.4%. With the increase of age, the proportion of eGFR decreased showed a rising trend(P<0.01). The proportion of microalbuminuria was 7.0%, 6.4% and 9.1%. With the increase of age, the proportion of microalbuminuria showed an upward trend(P<0.05). Coronary heart disease(CHD) in elderly hypertensive patients accounted for 37.4%, 47.4% and 55.0%, with the increase of age,the proportion of CHD was increased(P <0.01). Chronic heart failure(CHF) in elderly hypertensive patients accounted for 63.9%, 77.1% and 78.9%, with the increase of age, the proportion of CHF was increased(P <0.01).3. Comparison of pulse pressure level of different age groups, results showed that the pulse pressure level of 70~79 years group was higher than that of 60~69 years group(P<0.05); the pulse pressure level of ?80 years group was higher than that of 60~69 years group(P<0.05); the pulse pressure level of ?80 years group was higher than that of 70~79 years group(P<0.05).4. Divided elderly hypertensive patients in systolic BP <140mmHg group,140~149mmHg group,?150mmHg group, the proportion of eGFR decreased was 12.8%, 21.3% and 28.1%; the proportion of microalbuminuria was 5.7%, 19.4% and 14.4%, the difference between the two groups had statistical significance(P < 0.05). Logistic regression analysis showed that, with the rise of systolic BP, the risk of eGFR decreased was increased(OR: 1.565, 95%CI: 1.217,2.012); the risk of microalbuminuria was increased(OR: 1.510, 95%CI: 1.707, 2.061). ConclusionsThe risk factors and target organ damages in elderly hypertension patients were more common. In elderly hypertensive patients, the pulse pressure was higher, and the pulse pressure increaseed with the increasing of the age. With the rise of BP, the risk of renal function decreased was increased. Through the management of BP in elderly hypertensive patients had a positive significance to the improvement of renal function.