Influencing Factors And Prognosis Of Elderly Patients With Hypertension Complicated By Weakness

OBJECTIVE:The process of population aging has led to a significant increase in the incidence of hypertension in the elderly,and the increase in elderly hypertension also includes reversible cardiovascular risk factors associated with hypertension complications and mortality.The vast majority of elderly patients with hypertension are accompanied by physical weakness,debilitating syndrome is another major health problem of the elderly.Studies have shown that debilitating syndrome exists in the majority of elderly people,and some of these people with high blood pressure,their risk of adverse consequences may also increase.Although the preliminary evidence shows that the relationship between hypertension and asthenia syndrome remains to be discussed,it needs to be further verified in different sample cases.Therefore,in this study,we will explore the influencing factors of senile hypertension patients with debilitation,and observe the effect of debilitation on the adverse events of senile hypertension patients.METHODS:From October 2017 to June 2019,the study selected the patients who visited the general medicine department of Hefei hospital affiliated to Anhui Medical University / the second people's Hospital of Hefei City as the research objects,and completed the evaluation of senile debilitation by the Tilburg debilitation scale.After admission,general information,chronic history,blood pressure control and management,relevant indicators and adverse events were collected.Meanwhile,blood samples were collected to check the changes of blood routine,liver function,renal function and other indicators.All the observation data were collected and analyzed by SPSS17.0 statistical software.The measurement data was expressed by " " and the count data was x±Sexpressed by percentage.The paired t-test was used to compare the measurement data,the group t-test was used to compare the group,and the ? 2 test was used to count the data.The risk relationship between multiple factors and debilitation was analyzed by two categories logistic regression model,and the risk relationship between laboratory related data and debilitation was detected by Pearson correlation coefficient.Kaplan Meier survival analysis was used for adverse events and readmission events,and the detection result was p < 0.05.RESULTS:1.245 elderly patients with hypertension were included in the study,including 129 males and 116 females,with an average age of 73.52 ± 8.62 years(60-97 years).There were 189 Elderly Hypertensive Patients with debilitation after the evaluation of Tilburg scale,accounting for 77.14% of the total patients,including 138 patients with mild debilitation(Tilburg scale score 5-7),44 patients with moderate debilitation(8-10)and 7 patients with severe debilitation(>10),respectively.In all the subjects,the average total score of debilitation was 5.26 ± 2.87,including 3.87 ± 0.46 for physical debilitation,2.52 ± 0.37 for psychological debilitation,and 1.36 ± 0.28 for social debilitation.2.The age(P < 0.05),lower education level(P <0.05)and marital status(P<0.05)in the general data were closely related to the debilitation.The risk of more than two kinds of chronic diseases was increased in the debilitating group compared with the non debilitating group,and the history of type 2 diabetes(P<0.05),heart function were also affected in the debilitating group The incidence of disability(P<0.05),chronic obstructive pulmonary disease(P<0.05),cerebrovascular disease(P<0.05),Parkinson's disease(P<0.05)and osteoporosis(P<0.05)were significantly higher.= 1.629(1.232 ? 2.873)] and osteoporosis The history of relaxation [or = 3.437(2.887-4.762)] was an independent predictor of weakness.The results showed that patients in the weak group the levels of red blood cells(P=0.016),hemoglobin(P=0.027),creatinine(P<0.05),Cystatin C(P<0.05)and homocysteine(P<0.05)were higher than those in the non-weak group.Pearson correlation analysis showed that the score of debilitation was positively correlated with the scores of homocysteine(P<0.05)and homocysteine(P<0.05).3.In different grades of hypertension,the higher the grade,the higher the detection rate of debilitation.In the elderly patients with hypertension and debilitation,the percentage of 24-hour systolic and diastolic pressure variation was significantly higher than that in the non debilitating group(P<0.05),and the results showed that the systolic and diastolic pressure in the debilitating group were significantly higher than that in the non debilitating group(P<0.05).In terms of hospitalization indexes,the hospitalization time of elderly patients with hypertension and debilitation was 14.29 ± 3.76 days,which was more than 11.52 ± 3.98 days in the non debilitating group(P < 0.05);the average medical expenses in the debilitating group was 8927.32 ± 1822.23 yuan,also more than 7392.81 ± 1529.21 yuan in the non debilitating group(P<0.05).Finally,we found that debilitation was also an independent risk factor for predicting readmission(P<0.05)and adverse events(P<0.05).CONCLUSION:1.The prevalence of asthenia in elderly patients with hypertension is high,which is related to age,education level,history of chronic disease ? 2,history of type 2 diabetes,history of Parkinson's disease,history of cerebrovascular disease,history of chronic obstructive pulmonary disease and history of osteoporosis.2.Frailty is an independent risk factor for predicting readmission and adverse events in elderly patients with hypertension.