Study On The Correlation Between Variation Of Blood Pressure And Frailty In The Aged

Objective:Through the analysis and comparison of 24 hours,daytime and night systolic blood pressure and diastolic blood pressure variability of frailty,pre-frailty and non-frailty elderly patients,understand the characteristics of blood pressure fluctuation in elderly frailty population,and explore the relationship between frailty syndrome and blood pressure variation in elderly.Methods:93 elderly patients admitted to the geriatric department of the affiliated hospital of Qingdao university from January 2018 to October 2018 were selected and grouped according to Fried frailty scale,including 31 cases in the frailty group,31 cases in the pre-frailty group and 31 cases in the non-frailty group.General information of patients,comorbidity,number of drugs taken,blood biochemical values were collected,and 24-hour ambulatory blood pressure monitoring was conducted for each group,and mean systolic and diastolic blood pressure for 24 hours,day and night were analyzed.Standard deviation of 24-hour,daytime and nighttime systolic blood pressure and 24-hour,daytime and nighttime diastolic blood pressure;24-hour pulse pressure difference,daytime pulse pressure difference and nighttime pulse pressure difference;The 24-hour,daytime and nighttime systolic pressure load values and the 24-hour,daytime and nighttime diastolic pressure load values were used to determine the relationship between blood pressure variability and frailty in old age.Using SPSS 21.0 statistical software,express as a percentage of the number of cases and count data.Measurement data by (?),count data by chi-square test,compare the single factor analysis of variance among groups.The Spearman rank correlation analysis was used to explore the correlation of frailty and blood pressure variation index,with P<0.05 for the difference was statistically significant.Result:1.The number of people aged 80 years old in the frailty group accounted for 87.1% of the total number of people observed,which was significantly higher than that in the pre-frailty group(64.5%)and the non-frailty group(29%),and the difference was statistically significant(P<0.05).2.The number of drugs in the frailty group was significantly higher than that in the non-frailty group,and the difference was statistically significant(P< o.05);3.The number of patients with comorbid in the pre-frailty group and the frailty group was more than that in the non-frailty group,and the difference was statistically significant(P<0.05).4.Serum albumin(ALB)and high-density lipoprotein(HDL-C)in the frailty group and the pre-frailty group were significantly lower than those in the non-frailty group,with statistically significant differences(P< 0.01).There were no significant differences in serum cholesterol(TC),triglyceride(TG),low-density lipoprotein(LDL-C)and creatinine(CR)levels among the frailty group,the pre-frailty group and the non-frailty group(P > 0.05).5.The 24-hour systolic blood pressure and diurnal systolic blood pressure in the pre-frailty group and the non-frailty group were significantly higher than those in the younger and older elderly group,with statistically significant differences(P<0.01).There were no statistically significant differences in 24-hour diastolic blood pressure,diurnal diastolic blood pressure,nocturnal systolic blood pressure and nocturnal diastolic blood pressure(P>0.05).6.Logistic regression analysis showed that serum albumin and high-density lipoprotein were protective factors for senile frailty,and age was the independent risk factor for senile frailty.7.Spearman correlation analysis showed that in the younger elderly group 24-hour systolic blood pressure standard deviation,diurnal systolic blood pressure standard deviation and nighttime systolic blood pressure standard deviation were positively correlated with frailty(r=0.662,P=0.000;r=0.623,P=0.000;r=0.580,P=0.000).In the older elderly group 24-hour pulse pressure difference,diurnal pulse pressure difference,and nighttime pulse pressure difference were positively correlated with frailty(r=0.479,P=0.001;r=0.447,P=0.002;r=0.399,P=0.007).The values of 24-hour diastolic pressure load,diastolic pressure load during daytime and diastolic pressure load at night were negatively correlated with frailty(r=-0.593,P=0.000;r=-0.637,P=0.000;r=-0.467,P=0.001).24-hour systolic blood pressure standard deviation,diurnal systolic blood pressure standard deviation and nighttime systolic blood pressure standard deviation were positively correlated with frailty(r=0.762,P=0.002;r=0.732,P=0.000;r=0.621,P=0.000).24-hour pulse pressure difference,diurnal pulse pressure difference,and nighttime pulse pressure difference were positively correlated with frailty(r=0.454,P=0.001;r=0.408,P=0.002;r=0.366,P=0.001).The values of 24-hour diastolic pressure load,diastolic pressure load during daytime and diastolic pressure load at night were negatively correlated with frailty(r=-0.537,P=0.000;r=-0.591,P=0.000;r=-0.382,P=0.001).Conclusion1.Age,the types of the drugs taken orally,comorbidity,serum albumin,high-density lipoprotein(HDL-C)and other factors affect frailty syndrome;2.Compared with the pre-frailty group and the non-frailty group,patients in the frailty group had significantly lower 24-hour systolic blood pressure and diurnal systolic blood pressure;3.Serum albumin and HDL are protective factors for frailty in old age,and age is an independent risk factor for frailty in old age;4.The more severe the frailty of the elderly patients,the higher the standard deviation of systolic blood pressure and pulse pressure difference,and the lower the diastolic pressure load value;5.The augment of blood pressure fluctuation may increase the risk which is suffering from frailty ayndrome in the elderly.