The Study Of The Influence With Frailty On Treatment Of Hypertension In The Elderly

Objectives: This study is to analyze the effects of frailty on the treatment of hypertension in the elderly person,to measure the blood pressure in the morning before taking the medicine and the 24 hours ambulatory blood pressure changes after taking the medicine in elderly patients with hypertension,to understand the changes in the relevant indicators of the elderly hypertensive patients under different degrees of frailty,and compare the differences of the three groups of patients,to provide a basis for early diagnosis of frailty syndrome and effective control of blood pressure.Methods: A total of 174 elderly patients with hypertension who were treated in the Affiliated Hospital of Hang Zhou Normal University from February 2018 to November 2019 were randomly selected,including 94 males and 80 females.According to the results of the frailty index(FI)scale,the patients were divided into non-frail group(58 cases),pre-frail group(69 cases)and frail group(47 cases).The clinical data were collected by blind method.The three groups of patients were recorded:(1)basic situation(2)biochemical index(3)multiple medications(4)blood pressure control level(5)chronic disease.Early morning blood pressure,daytime average blood pressure,nighttime average blood pressure and 24-hour average blood pressure were recorded through 24-hour ambulatory blood pressure monitoring.Descriptive analysis,t-test,chi square test and other statistical methods were applied for statistical data analysis.Results: The total cholesterol,triglyceride,creatinine and uric acid levels were not statistically different among the three groups of patients(P>0.05),but significant difference in LVEF(P<0.05)was observed.There was no significant differences in arrhythmia,chronic heart failure,diabetes,COPD and cancer among the three groups(P>0.05),between the frail group and the non-frail group and the pre-frail group with ischemic cardiomyopathy and stroke he differences were statistically significant(P<0.05);Comparison of drugs used in patients with different frail conditions: ARB,CCB,?-blockers,?-blockers,and diuretics were not significantly different(P>0.05),the frail group was compared with the non-frail and pre-frail groups There were statistical differences in the use of ACEIs to control blood pressure(P<0.05);There was a statistically significant difference between the combination group and the single group in the frail group(P <0.05).There was no significant difference in morning SBP among the three groups(P>0.05).Compared with the pre-frail group and the frail group,the morning DBP was statistically significant(P<0.05);there were no significant differences in 24 h DBP,24 h SBP,daytime DBP,daytime SBP and nighttime DBP between the three groups(P>0.05).SBP in the nighttime was statistically significant in the non-frail group compared with the pre-frail group and the frail group(P<0.05)The patients in three groups were further classified by logistic regression analysis.Logistic regression analysis of ordered classification data was performed in the three groups of patients,and the frail was statistically significant with early morning SBP,early morning DBP,24 h SBP,and 24 h DBP(P<0.05).Conclusions: The severity of frailty affects the cardiac ejection of elderly patients with hypertension;Frailty elderly hypertensive patients are prone to ischemic cardiomyopathy and stroke;The severity of frailty affects the morning systolic blood pressure and 24-hour average blood pressure of elderly patients with hypertension under the treatment of drugs.