Abstract WMP57: Declining Blood Pressure is Associated with Subcortical Microinfarcts in Older Adults

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mekala R Raman ◽  
Jonathan Graff-Radford ◽  
Scott A Przybelski ◽  
Timothy G Lesnick ◽  
Michelle M Mielke ◽  
...  

Hypertension is highly prevalent in the elderly population and microinfarcts are the most common vascular brain pathology identified in older adults at autopsy. We investigated the associations between systolic and diastolic blood pressures measured antemortem and the presence of microinfarcts at autopsy. Study subjects (n=302; age range=71-95) were participants in the population-based Mayo Clinic Study of Aging autopsy study, who had blood pressure measurements recorded during life. We investigated both cross-sectional systolic and diastolic blood pressure measurements at the baseline visit and the change in blood pressure (slope). Presence and location (subcortical or cortical) of chronic microinfarcts was abstracted from the autopsy reports. Of the 302 study subjects, 47 (16%) had cerebral microinfarcts, and, of those, 18 (38%) had subcortical microinfarcts and 29 (62%) had only cortical microinfarcts. The baseline blood pressures were not different between subjects with no microinfarcts, subcortical microinfarcts, and only cortical microinfarcts. In a logistic regression model including time between last blood pressure measurement and death, a greater decline in systolic [OR= 1.06 (1.01, 1.11); p=0.02]) and greater decline in diastolic [OR= 1.11 (1.02, 1.20); p=0.01] blood pressures were predictors of the presence of subcortical microinfarcts at autopsy. However, these variables were not associated with the presence of cortical microinfarcts. In conclusion, microinfarcts are common in the older adult population, and most of them are located in the cortex. A greater decline in both systolic and diastolic blood pressures and their association with subcortical microinfarcts, but not with cortical microinfarcts, may have implications for aggressive lowering of blood pressure in the elderly population.

Author(s):  
C. Dussaillant ◽  
G. Echeverría ◽  
L. Villarroel ◽  
C.B. Yu ◽  
A. Rigotti ◽  
...  

Objectives: To analyze the relationship between the prevalence of metabolic syndrome, food intake, and diet quality in elderly (≥65 years old) Chilean population. Design: Cross sectional analysis based on the last national health survey performed in the years 2009 and 2010 (ChNHS 2009-2010). Setting: Non-institutionalized individuals of 65 years or older were selected and visited at home. Participants: A subsample of 505 elderly adults from the ChNHS 2009-2010 who answered a food questionnaire and had appropriate information to diagnose metabolic syndrome following the ATPIII-NCEP guidelines. Measurements: Fasting blood samples were obtained in order to measure blood lipids and fasting blood glucose. Blood pressure, waist circumference, and body mass index (BMI) were also measured. A 5-item food frequency questionnaire was applied to all the participants of NHS 2009-2010. Results: The overall prevalence of metabolic syndrome in the Chilean adult population was 37.7%, increasing in frequency with advancing age. Among the elderly (≥65 years old), metabolic syndrome was found in 57.2% of the sample. Elevated blood pressure and increased waist circumference were the most prevalent metabolic syndrome components among this group (88% and 80%, respectively). Low intake of fruits, vegetables, whole cereals, fish, and dairy was seen among the elderly, and no association was found between food intake nor diet quality and metabolic syndrome prevalence. Conclusion: Metabolic syndrome is highly prevalent among the Chilean elderly population and its prevalence is not associated with food intake or diet quality in this age group.


2021 ◽  
Vol 5 (2) ◽  
pp. 65-72
Author(s):  
Siti Roziah Ria Famuji ◽  
Abdul Malik Setiawan ◽  
Achdiat Agoes

Hypertension affects approximately 26% of the adult population and it is a leading cause of death in up to 13.5% worldwide. Hypertension is a disease with the highest prevalence in Indonesia, so good treatment and prevention are needed. Several studies suggest that there is a correlation between hypertension risk factors and the disturbance of sleep quality. Therefore, it is necessary to develop preventive and promotive efforts to obtain optimum blood pressure in patients with hypertension to avoid complications or even death. This study aims to find out the correlation between sleep quality and the value of blood pressure in the elderly ?60 years old in Batu City. A cross-sectional study was conducted in Batu City in 2020. Stratified random sampling was performed to select the respondents. A validated PSQI questionnaire and sphygmomanometer were used to assess sleep quality and blood pressure, respectively. A Chi-Square test was used to test the hypothesis. There were 391 respondents involved in this study. Most of the respondents have poor sleep quality, 205 respondents (52,43%) of which 41 respondents (20%) have normal blood pressure, and 164 respondents (80%) have high blood pressure. The statistical analysis shows a significant correlation (p=0,000) between sleep quality and blood pressure. In conclusion, hypertension is associated with poor sleep quality in the geriatric population in Batu City.


2020 ◽  
Vol 22 (Supplement_H) ◽  
pp. H119-H121
Author(s):  
Enrique Rodilla ◽  
Ana Molinero ◽  
Teresa Gijón-Conde ◽  
Salvador Tous ◽  
José A Fornós ◽  
...  

Abstract Elevated blood pressure (BP) is the single most important contributing risk factor to the global disease burden, leading to over 10 million deaths each year. In Spain, hypertension (HTN) affects around 20% of the adult population and remains the greatest attributable cause of cardiovascular mortality. May Measurement Month (MMM) is a worldwide initiative aimed at increasing awareness of HTN and to improve the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged 18 and over was carried out in May 2018. Blood pressure measurement, the definition of HTN and statistical analysis followed the standard MMM protocol. Anthropometric data and responses to questionnaires on demographic, lifestyle, and environmental factors were obtained as additional information. Screening sites mainly in community pharmacies, universities, primary care centres, HTN units, and cardiovascular departments in hospitals were set up across Spain as part of this initiative. In total, 7646 individuals (63.5% female) were screened during MMM18. After multiple imputation, 40.0% had HTN, of whom 74.4% were aware of their diagnosis and 69.6% were taking antihypertensive medication. Of individuals not receiving antihypertensive medication, 16.9% were hypertensive. Of individuals receiving antihypertensive medication, 36.4% had uncontrolled BP. MMM18 almost doubled the number of participants of MMM17 and was the largest BP screening campaign ever undertaken in Spain, showing that in the absence of systematic screening programmes for HTN, MMM can identify a great number of individuals at risk, increasing their awareness and attracting the interest of the healthcare system in Spain.


Author(s):  
Zaozianlungliu Gonmei ◽  
Supriya Dwivedi ◽  
Gurudayal Singh Toteja ◽  
Karuna Singh ◽  
Naval Kishore Vikram

 Objective: The present study was carried out to assess the prevalence of hypertension among elderly in slums of West Delhi.Methods: A cross-sectional study was carried out among 202 elderly residing in urban slums of West Delhi. Hypertension was classified as per JNC VII criteria. Blood pressure was measured twice using digital machine (OMRON) after an interval of 5 min. The data obtained were analyzed for percent prevalence, mean, standard deviation, and median.Results: The overall prevalence of hypertension was 49.1%; higher among male (56.0%) than female (41.9%). The prevalence of Stage I, Stage II, and isolated systolic hypertension was 30.7%, 18.8%, and 47%, respectively.Conclusion: Almost half of the elderly population in slums was hypertensive. Periodical health checkup and management through treatment and dietary and lifestyle modification is needed. 


2014 ◽  
Vol 18 (4) ◽  
pp. 256-264 ◽  
Author(s):  
Samantha Gontijo Guerra ◽  
Michel Préville ◽  
Helen-Maria Vasiliadis ◽  
Djamal Berbiche

Background: Depression is frequently observed in dermatologic patients. However, the association between depressive disorders and skin conditions has rarely been explored through population-based studies, especially within older-adult populations. Objective: To test this association in a representative sample of an older-adult population. Methods: Data came from the Survey on the Health of the Elderly (Enquête sur la Santé des Aînés [ESA]), a longitudinal survey conducted in Quebec among 2,811 older adults. Cross-lagged panel models were used to simultaneously examine cross-sectional and longitudinal relationships between the presence of skin conditions and depressive disorders. Results: The prevalence of skin conditions was 13%, and the prevalence of depressive disorders among participants presenting with skin conditions was 11%. Our results indicated significant cross-sectional correlation ( ζ = 0.20) between skin conditions and depressive disorders, but no longitudinal association was observed. Conclusion: Our results reinforce the hypothesis that skin conditions and depressive disorders are concurrently associated in older adults. However, no evidence of the predictive effect of skin problems on depression (and vice versa) was found in our community sample. Despite the deleterious effect of the coexistence of these problems in older adults, studies are lacking. This article highlights the importance of this issue and emphasizes the need for further research on this topic.


Author(s):  
Eduardo Expedito Valeriano Batista ◽  
Bruno Almeida Rezende

Estudar o perfil do idoso portador de Hipertensão Arterial Sistêmica (HAS) inserido em um Grupo de Apoio a Terceira Idade (GATI), sua adesão ao tratamento medicamentoso e o controle dos níveis pressóricos. Estudo transversal, descritivo e comparativo em 72 idosos portadores de HAS divididos em dois grupos: participantes e não participantes de um GATI na cidade de Jequeri (MG). Os dados foram coletados por entrevistas através do questionário de adesão a medicamentos auto referido, aferição da pressão arterial e coleta de dados do prontuário. A maioria dos indivíduos era do sexo feminino, casados e praticavam atividades físicas regulares. Os participantes do GATI apresentaram maior escolaridade, maior adesão ao tratamento medicamentoso da HAS, maior proporção de praticantes de atividades físicas, menor IMC e menor proporção de fumantes e melhores índices pressóricos. A implementação de GATI pode auxiliar no controle dos níveis pressóricos em pacientes portadores de HAS.Descritores: Hipertensão Arterial Sistêmica, Idoso, Envelhecimento. Effectiveness of a support program for the elderly in the control of Systemic Arterial HypertensionAbstract: To study the profile of elderly patients with Systemic Arterial Hypertension (SAH) included in a support program for elderly people (SPEP) at Jequeri city (MG), as well as their drug treatment adherence and control of blood pressure levels. Cross-sectional, descriptive and comparative study performed in 72 elderly patients with SAH divided into two groups: participants and non-participants of a SPEP. The data were collected by interviews through a self-reported adherence questionnaire, blood pressure measurement, as well as the collection of relevant information to the patient’s medical record. Most of the individuals were female, married, and engaged in regular physical activity. SPEP participants presented higher schooling, greater adherence to the medical treatment of hypertension, greater proportion of physical activity practitioners, lower BMI, a lower proportion of smokers and better blood pressure indexes. The implementation of SPEP can help control pressure levels in patients with SAH.Descriptors: Systemic Arterial Hypertension, Elderly, Senior group, Aging. Efectividad de programa de apoyo a la tercera edad en el control de la hipertensión arterialResumen: Estudar o perfil do idoso portador de Hipertensão Arterial Sistémica (HAS) inserido em um Grupo de Apoio a Terceira Idade (GATI), sua adesão ao tratamento medicamentoso e o controle dos níveis pressóricos. Estudo transversal, descritivo e comparativo em 72 idosos portadores de HAS divididos em dois grupos: participantes e não participantes de um GATI na cidade de Jequeri (MG). Os dados foram coletados por entrevistas através do questionário de adesão a medicamentos auto referido, aferição da pressão arterial e coleta de dados do prontuário. A maioria dos indivíduos era do sexo feminino, casados e praticavam atividades físicas regulares. Os participantes do GATI apresentaram maior escolaridade, maior adesão ao tratamento medicamentoso da HAS, maior proporção de praticantes de atividades físicas, menor IMC e menor proporção de fumantes e melhores índices pressóricos. A implementação de GATI podem auxiliar no controle dos níveis pressóricos em pacientes portadores de HAS.Descriptores: Hipertensão Arterial Sistêmica, Idoso, Envelhecimento.


2019 ◽  
Vol 32 (8) ◽  
pp. 777-785 ◽  
Author(s):  
Yi Chen ◽  
Qi-Fang Huang ◽  
Chang-Sheng Sheng ◽  
Lei Lei ◽  
Shao-Kun Xu ◽  
...  

Abstract OBJECTIVE Atrial fibrillation (AF) and hypertension are prevalent chronic disease conditions in the elderly population. In the present cross-sectional study, we investigated the association between blood pressure (BP) and AF in an elderly Chinese population. METHOD Our elderly (≥65 years) subjects were residents recruited from 6 communities in Shanghai from 2006 to 2017. Atrial fibrillation was systematically screened by rest 12-lead electrocardiogram (ECG) or by a handheld single-lead ECG. BP status was defined according to the European hypertension guidelines as optimal, normal, or high-normal BP, and stage 1, 2, or 3 hypertension. RESULT In the 6,966 participants (women 56.0%, mean age: 72.3 years), the prevalence of AF was 3.3%, and the prevalence of hypertension was 58.7% (83.7% treated). In all participants, the association with prevalent AF was negative for systolic BP (odds ratio [OR] per 10-mm Hg increase 0.79, 95% confidence interval [CI]: 0.71–0.88, P < 0.0001) but positive for diastolic BP (OR per 5-mm Hg increase 1.11, 95% CI: 1.02–1.22, P = 0.02). In untreated participants (n = 3,544), the association with prevalent AF was U-shaped for both systolic and diastolic BP, with the nadir at high-normal BP and a significantly higher risk of prevalent AF in optimal systolic BP (OR: 3.11, 95% CI: 1.65–5.85, P = 0.004) and stage 2 or 3 diastolic hypertension relative to the nadir (OR: 8.04, 95% CI: 2.28–28.3, P = 0.001). CONCLUSION In the elderly population, BP shows a complicated relationship with prevalent AF, with high-normal BP at the lowest risk and optimal systolic BP and stage 2 or 3 diastolic hypertension at increased risks.


2021 ◽  
Vol 10 (1) ◽  
pp. 1-6
Author(s):  
Selcuk Mistik ◽  
Kevser Goktas ◽  
Demet Unalan ◽  
Abdurrahman Oguzhan ◽  
Bulent Tokgöz

Aim: Hypertension is very common in primary care patients. The diagnosis of hypertension is made by office measurements and home blood pressure measurements. The aim of this study was to define the normal variation levels of blood pressure in individuals in primary care by using ambulatory blood pressure measurement. Methods: This study was performed in primary care. Individuals who had no hypertension history were included in the study. Subjects were evaluated by using three office measurements, seven days home blood pressure measurements and 24 hours ambulatory blood pressure measurement. The ambulatory blood pressure gave us the variations in blood pressure values. Results: The study started in January 2018 and ended in May 2018. Of the 47 subjects, 70.2% were women and 29.8% were men. The mean age was 41.63±12.00. The most common educational level was elementary school graduates. The most common occupation was housewives. Of the participants, 84.2% were married. At ambulatory blood pressure measurements, 34.0% of the subjects had mean systolic blood pressures 24 hours between 120-129 mmHg. Of the diastolic blood pressure 24 hours mean values, 15.3% had values between 80-89, where 51.0% were between the 71-79 mmHg groups. The mean value of 24 hours variation in systolic blood pressure was 15.75±18.59 (median=11.40, min=8.80, max=106.00). The 24 hours variation in the mean values of diastolic blood pressures was 12.12±10.90 (median=9.70, min=6.80, max=64.00). Conclusion: The results of this study demonstrated that there were high levels of variations in normal blood pressures, which could show candidates for hypertension. Keywords: ambulatory monitoring, blood pressure, variability, primary care


2020 ◽  
Vol 7 (1) ◽  
pp. 116-122
Author(s):  
Susanti Susanti ◽  
Caturia Sasti Sulistyana

Salah satu gangguan kesehatan yang banyak dialami oleh lansia adalah pada sistem kardiovaskuler yaitu hipertensi. Pada berbagai posisi akan menghasilkan tekanan darah yang bervariasi. Penelitian ini bertujuan untuk mengetahui hasil pengukuran tekanan darah pada lansia yang menderita hipertensi antara posisi duduk dan posisi berdiri. Penelitian ini dilaksanakan di RW 06 Kelurahan Bongkaran Sejahtera Kecamatan Pabean Cantian Surabaya pada 27 Januari 2018. Metode pada penelitian  yaitu  pra eksperimental dengan tipe one group pre post test design dengan pendekatan cross sectional. Sampel penelitian ditentukan secara total sampling yang berjumlah 50 orang. Data dianalisa menggunakan  uji  Wilcoxon Signed Ranks Test. Hasil penelitian menunjukan terdapat pengaruh posisi tubuh  terhadap tekanan darah. Hasil penelitian yang diperoleh sebagai berikut: tekanan darah yang diukur pada saat duduk sebesar 29 orang (58%) dikategorikan Hipertensi Derajat 1, sedangkan posisi berdiri sebesar 20 orang (34%) dikategorikan Hipertensi Derajat 2. Hasil uji Wilcoxon Signed Ranks Test menunjukkan bahwa terdapat perbedaan yang bermakna antara posisi duduk dan posisi berdiri dengan nilai p = 0,000 < α =0,05. Kecepatan denyut jantung akan meningkat pada posisi duduk karena jantung memompa darah akan lebih keras sehingga melawan gaya gravitasi. Hal ini membuat tekanan darah cenderung stabil.. Pengukuran tekanan darah dapat dilakukan pada  posisi tubuh yang lain dengan perbedaan waktu istirahat, dan berikan interval waktu dalam melakukan pengukuran tekanan darah. One of the many health problems experienced by the elderly is the cardiovascular system, that is hypertension. Blood pressure varies in a wide range of circumstances, one of which is the change in position. The purpose of this research is to know the results of the measurement of the blood pressure between sitting position and standing position on the elderly who suffer from hypertension. This research was carried out in the prosperous Village 06 RW Bongkaran Sejahtera Kecamatan Pabean Cantian Surabaya on 27 January 2018. Research on the methods of experimental type with pre eksperiment one group pre post test design with cross sectional approach. Sample determined in simple random sampling of 50 people. The data were analyzed using the Wilcoxon Signed Ranks test. The results showed there are. influence of the position of the body against blood pressure. The research results obtained the following data: blood pressure sitting of 29 people (58%) categorized Hypertension Degrees 1, while a sitting position by 20 people (34%) categorized Hypertension Degrees 2. Test results Wilcoxon Signed Ranks Test showed that there were significant differences between the positions of sitting and standing position with a value of p = 0.000<α = 0.05. Seated position makes blood pressure tend to be stable. Working the heart in a sitting position, in pumping blood will be harder because it opposes the gravitational force so that the heart rate increases. Blood pressure measurement can be done a variety of positions, the time difference break, as well as to provide an interval of time in doing the measurement of blood pressure.


2002 ◽  
Vol 5 (5) ◽  
pp. 645-654 ◽  
Author(s):  
Paul N Appleby ◽  
Gwyneth K Davey ◽  
Timothy J Key

AbstractObjective:To compare the prevalence of self-reported hypertension and mean systolic and diastolic blood pressures in four diet groups (meat eaters, fish eaters, vegetarians and vegans) and to investigate dietary and other lifestyle factors that might account for any differences observed between the groups.Design:Analysis of cross-sectional data from participants in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC–Oxford).Setting:United Kingdom.Subjects:Eleven thousand and four British men and women aged 20–78 years at blood pressure measurement.Results:The age-adjusted prevalence of self-reported hypertension was significantly different between the four diet groups, ranging from 15.0% in male meat eaters to 5.8% in male vegans, and from 12.1% in female meat eaters to 7.7% in female vegans, with fish eaters and vegetarians having similar and intermediate prevalences. Mean systolic and diastolic blood pressures were significantly different between the four diet groups, with meat eaters having the highest values and vegans the lowest values. The differences in age-adjusted mean blood pressure between meat eaters and vegans among participants with no self-reported hypertension were 4.2 and 2.6 mmHg systolic and 2.8 and 1.7 mmHg diastolic for men and women, respectively. Much of the variation was attributable to differences in body mass index between the diet groups.Conclusions:Non-meat eaters, especially vegans, have a lower prevalence of hypertension and lower systolic and diastolic blood pressures than meat eaters, largely because of differences in body mass index.


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