scholarly journals Relationship of anxiety-depressive disorders and cognitive dysfunction in patients with arterial hypertension depending on the age and status of physical activity

2020 ◽  
Vol 29 (3) ◽  
pp. 46-53
Author(s):  
T.V. Kolesnyk ◽  
A.V. Nadiuk ◽  
H.A. Kosova
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
Cognitive Functions ◽  
Physical Inactivity ◽  
Anxiety And Depression ◽  
Middle Aged ◽  
Aged Patients ◽  
Level Of Education

Objective – to determine the level of anxiety and depression, to investigate cognitive functions and the status of physical activity in patients with hypertension, depending on age.Materials and methods. We examined 67 patients with hypertension I–III stage (atherosclerotic plaque and/or myocardial infarction in history). According to age classification (WHO, 2012) patients were randomized into 3 groups: group I – 25 middle-aged patients, group II – 22 elderly patients, group III – 20 patients of senile age. The highest level of education, the total number of education years; duration of arterial hypertension; anthropometric data and the office blood pressure were assessed. We used an individual approach to determine the target level of blood pressure according to the recommendations ESC/ESH 2018. Cognitive functions were evaluated using the MoCA-test and the Clock Drawing Test. The level of anxiety and depression was determined by the results of the Hospital scale of anxiety and depression.Results. According to the data obtained, a statistically greater degree of depression was recorded among eldery patients in comparison with other groups. Only in this group, a higher level of depression was associated with less time that patients spent for regular exercise during the week. Among middle-aged patients with arterial hypertension, the absence of anxiety and depression was detected in 56.0 %. At the same time, in the group of senile age, 75.0 % of patients were diagnosed with manifestations of anxiety and depression of varying severity. It is important to notice that in the group of senile age the median level of anxiety was higher, although nonsignificantly, in comparison with other groups and met the criteria for subclinical anxiety. Results of multivariate correlation analysis showed that a high level of anxiety in middle-aged patients was associated with an earlier age of arterial hypertension verification, as well as with waist circumference increase and the waist/hip circumference ratio. Among elderly patients, a higher level of anxiety was determined in the presence of physical inactivity and among patients of senile age, an increase in anxiety level was associated with a shorter duration of education and a decrease in cognitive functions. Conclusions. The highest level of depression was diagnosed among people of senile age, which was associated with the presence of physical inactivity. The groups did not differ statistically in level of anxiety, however, an increase in its severity in the middle-aged group was associated with an earlier age of hypertension verification and an increase in the degree of abdominal obesity, among elderly patients – with hypodynamia, and in the group of senile age – with a low level of education and the presence of cognitive dysfunctions.

Age-associated features of the development of fibrosis and inflamaging in patients with arterial hypertension and ischemic stroke

2022 ◽  
pp. 879-884
Author(s):  
О.А. Осипова ◽  
Е.В. Гостева ◽  
О.Н. Белоусова ◽  
Н.И. Жернакова ◽  
Н.И. Клюшников ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
Old Age ◽  
Control Group ◽  
Cerebral Stroke ◽  
Middle Aged ◽  
Aged Patients ◽  
Tnf Α ◽  
Immune Inflammation

В статье рассмотрены вопросы развития фиброза и иммунного воспаления у больных артериальной гипертензией (АГ) с острым ишемическим инсультом (ИИ) в пожилом возрасте. Цель исследования - изучение возраст-ассоциированных особенностей концентрации маркеров фиброза (металлопротеиназы-9, тканевого ингибитора матриксных металлопротеиназ-1, их соотношения ММП-9/ТИМП-1), иммунного воспаления (TNF-α, IL-1β, INF-γ) у больных АГ с ИИ. В исследование были включены 86 больных АГ II степени, из которых 42 человека - среднего возраста (53±5 лет) и 44 - пожилого (66±5 лет), контрольную группу составили 22 пациента пожилого возраста с АГ без ИИ в анамнезе. Критерии включения - пациенты с АГ, поступившие в стационар в остром периоде первого церебрального инсульта. Установлено, что у пожилых больных АГ с ИИ показатели инфламэйджинга и маркеры фиброза были достоверно выше, чем у лиц среднего возраста. Уровень IL-1β был выше на 31,7 % (р<0,01), TNF-α - на 55,7 % (р<0,001), INF-γ - на 36,6 % (р<0,01), уровень ММП-9 - на 46,4 % (р<0,01), ТИМП-1 - на 21,2 % (р<0,01), ММП-9/ТИМП-1 - на 19,6 % (р<0,01) в пожилом возрасте по сравнению с больными среднего возраста с АГ и острым ИИ. Таким образом, установлено, что больные АГ с ИИ имеют нарушения процессов инфламейджинга, синтеза и деградации внеклеточного матрикса, особенно выраженные в пожилом возрасте. The article deals with the development of fibrosis and immune inflammation in patients with arterial hypertension and acute ischemic stroke in old age. The aim of the study was to study age-associated features of the concentration of fibrosis markers (metalloproteinase-9, tissue inhibitor of matrix metalloproteinases-1, their ratio MMP-9/TIMP-1), immune inflammation (TNF-α, IL-1β, INF-γ) in patients with arterial hypertension and ischemic stroke (AI). The study included 86 patients with arterial hypertension (AH) of the 2nd degree, of which 42 were middle-aged (53±5 years) and 44 elderly (66±5 years). The control group consisted of 22 elderly patients with AH without a history of AI. The criteria for inclusion in the study are patients with hypertension who were admitted to the hospital in the acute period of the first cerebral stroke. It was found that in elderly patients with hypertension with AI, the indicators of inflamaging and fibrosis markers were significantly higher than in middle-aged people. The level of IL-1β was 31,7 % higher (p<0,01), TNF-α by 55,7 % (p<0,001), INF-γ by 36,6 % (p<0,01), the level of MMP-9 was 46,4 % higher (p<0,01), TIMP-1 by 21,2 % (p<0,01), MMP-9/TIMP-1 by 19,6 % (p<0,01) in the elderly compared to middle-aged patients with hypertension and acute AI. Thus, it was found that patients with arterial hypertension and ischemic stroke have violations of the processes of inflamaging, synthesis and degradation of the extracellular matrix, especially pronounced in old age.

scholarly journals Effect of the fixed-dose combination Ekvator on blood pressure level and cognitive functions in elderly patients with arterial hypertension

2013 ◽  
Vol 10 (1) ◽  
pp. 76-79
Author(s):  
O D Ostroumova ◽  
E I Pervichko
Keyword(s):  
Blood Pressure ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
Antihypertensive Drug ◽  
Cognitive Functions ◽  
Blood Pressure Level ◽  
Pressure Level ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Dose Combination

The paper gives the data of the authors’ trial of the effect of the fixed-dose combination antihypertensive drug lisinopril + amlodipine on blood pressure level and cognitive functions in 25 elderly patients with grades 1–2 arterial hypertension. The test drug has a high antihypertensive efficacy, as shown by both routine blood pressure measurements and 24-hour monitoring data. The findings suggest that the fixed-dose combination antihypertensive drug lisinopril + amlodipine improves a number of parameters characterizing cognitive functions

scholarly journals Elderly Patient with Hypertension in General Practice: Clinical Features and Antihypertensive Therapy

2021 ◽  
pp. 61-66
Author(s):  
Viacheslav Zhdan ◽  
Yevdokiia Kitura ◽  
Maryna Babanina ◽  
Oksana Kitura ◽  
Maksym Tkachenko
Keyword(s):  
Blood Pressure ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
High Frequency ◽  
Antihypertensive Drugs ◽  
White Coat Hypertension ◽  
Aged Patients ◽  
Increased Risk ◽  
Treatment Of Hypertension

The prevalence of arterial hypertension (AH) increases with age: among people over 60 years old this index is more than 2 times higher in the general population, 2/3 of people over 65 years old suffer from hypertension. Among patients 65–89 years old with hypertension, 2/3 patients have isolated systolic hypertension (ISAG). Features of hypertension in the elderly patients are: lability of blood pressure (BP), increasing frequency of pseudohypertension, high frequency of «white coat hypertension», decreased sensitivity of pressor factors for antihypertensive drugs, high frequency of resistant to treatment of hypertension. The new recommendations of the European Society of Cardiology for the diagnosis and treatment of hypertension emphasize 2 groups of elderly patients: 65–79 years old and ≥80 years old, which described the epidemiological features, the prevalence of risk factors for cardiovascular events, blood pressure levels for antihypertensive therapy and target blood pressure, and the recommended principles of drug therapy that are different from young and middle-aged patients. For most patients, fixed combinations are indicated as starting AGT, but monotherapy is recommended for the treatment of hypertension in very elderly patients (over 80 years old) and elderly patients over 65 years old with senile asthenia. The decreasing of blood pressure should be gradual, taking into consideration the increased risk of orthostatic reactions at this age. European and American experts recommend os first-line drugs low doses of thiazide diuretics and calcium channel antagonists (mainly dihydropyridine), which are especially indicated in isolated systolic arterial hypertension to effectively reduce the frequency of cardiovascular complications in the treatment of elderly patients with hypertension.

scholarly journals Brain Perfusion, Cognitive Functions, and Vascular Age in Middle Aged Patients With Essential Arterial Hypertension

Kardiologiia ◽  
2018 ◽  
Vol 17 (5) ◽  
pp. 23-31
Author(s):  
V. A. Parfenov ◽  
◽  
T. M. Ostroumova ◽  
E. M. Pеrepelova ◽  
V. A. Perepelov ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Cognitive Functions ◽  
Brain Perfusion ◽  
Middle Aged ◽  
Aged Patients ◽  
Essential Arterial Hypertension ◽  
Vascular Age

scholarly journals Efetividade de programa de apoio a terceira idade no controle da hipertensão arterial

2019 ◽  
Vol 9 (28) ◽  
pp. 26-36
Author(s):  
Eduardo Expedito Valeriano Batista ◽  
Bruno Almeida Rezende
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
Blood Pressure Measurement ◽  
The Elderly ◽  
Relevant Information ◽  
Support Program ◽  
Cross Sectional ◽  
Systemic Arterial Hypertension

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.

scholarly journals Nutritional status of elderly surgical patients

Medicina ◽  
2008 ◽  
Vol 44 (8) ◽  
pp. 609 ◽  
Author(s):  
Gytė Damulevičienė ◽  
Vita Lesauskaitė ◽  
Jūratė Macijauskienė
Keyword(s):  
Cognitive Function ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Cognitive Functions ◽  
Older Patients ◽  
Depression Scale ◽  
Surgical Patients ◽  
Middle Aged ◽  
Aged Patients ◽  
Impaired Cognitive Function

The aim of this study was to assess nutritional status of aged surgical patients, to determine the prevalence of malnutrition and factors associated with it. Material and methods. A total of 156 patients aged 45 years and more, treated at the Departments of Surgery and Urology of Kaunas 2nd Clinical Hospital, were enrolled in the study. Elderly group (aged 65 years and more) consisted of 99 patients, and middle-aged group (45 to 64 years old) of 57 patients. The following anthropometric measurements were performed: weight, height, mid-arm circumference; hemoglobin, serum albumin level, and total lymphocyte count were determined. Standard assessment scales included Instrumental Activities of Daily Living, Geriatric Depression Scale, and Mini Mental State Exam. Statistical analysis was performed with the help of SPSS 12.0. Results. Malnutrition was diagnosed in 53.5% of older patients and in 15.8% of middle-aged patients (P<0.05). Obesity was diagnosed in 32.3% of elderly patients and in 40.4% of middle-aged patients (P<0.05). Among men, obese patients made up 20%, among women – 54.4% (P<0.05). Malnutrition was more prevalent among elderly patients who underwent urgent operations than in patients who underwent planned operations (69.6% and 34.1%, respectively; P<0.05) and among elderly patients with impaired cognitive functions than among those without impaired cognitive functions (in 100% of patients with medium impaired cognitive function, in 59.3% of patients with mild impaired cognitive function, and in 44.4% of patients with unimpaired cognitive function, P<0.05). Malnourished elderly patients had lower functional level than the remaining (IADL score of 3.97 and 4.75 for men, 5.38 and 6.89 for women, respectively; P<0.05). The prevalence of malnutrition did not differ significantly in the groups of older patients with depression, probable depression and not depressed patients – 75.0%, 57.7%, and 46.7%, respectively (P>0.05). Conclusions. Malnutrition was diagnosed more frequently in elderly surgical patients than in middle-aged patients. Obesity was more common in women than in men. The prevalence of obesity was not associated with age. Malnutrition in elderly surgical patients was associated with poor functional status, impaired cognitive function, and urgent operation.

scholarly journals Effect of indapamide/perindopril fixed-dose combination on 24-hour blood pressure and cognitive functions in treatment-naive middle-aged patients with essential arterial hypertension

2018 ◽  
Vol 10 (3) ◽  
pp. 19-28 ◽  
Author(s):  
T. M. Ostroumova ◽  
V. A. Parfenov ◽  
O. D. Ostroumova ◽  
E. V. Borisova
Keyword(s):  
Blood Pressure ◽  
Cognitive Functions ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Middle Aged ◽  
Aged Patients ◽  
Treatment Naïve ◽  
Essential Arterial Hypertension ◽  
Dose Combination

Objective: to investigate the effect of indapamide/perindopril fixed-dose combination (FC) on 24-hour blood pressure (BP) and cognitive functions in antihypertensive treatment-naive middle-aged patients with uncomplicated grade 1–2 essential arterial hypertension (EAH) . Patients and methods. The open prospective study enrolled 25 patients (9 men and 16 women) aged 40–59 years with a diastolic BP of 90–109 mm Hg and/or a systolic BP of 140–179 mm Hg, as evidenced by routine measurements. As starting antihypertensive therapy, the patients received indapamide 1.25/perindopril 5 mg FC once daily in the morning; if necessary, after 2 weeks (if the routine blood pressure was ≥140/90 mm Hg) they took indapamide 2.5/perindopril 10 mg once daily in the morning. The follow-up period was 14–16 weeks. Before and at the end of the follow-up, the patients underwent 24-hour ambulatory BP monitoring (ABPM) and evaluation of cognitive functions using the Montreal Cognitive Assessment (MoCA), ten-words test (immediate and delayed word recall), verbal association test (literal and categorical associations), number connecting test (Trail making test (TMT), part A and numbers and letters connecting test (TMT) part B), and Stroop test. Results. At the end of the follow-up period, treatment with indapamide/perindopril fixed-dose combination showed a statistically significant reduction in BPs, as evidenced by routine measurements and ABPM (during 24-hour, and awake and sleep periods); a statistically significant cognitive improvement: an increase in the number of the so-called words in the ten-words test during both immediate (from 5.5±1.6 6.5±1.5 words; p=0.02 vs baseline) and delayed (from 6.2±1.7 to 7.4±1.4 words; p=vs baseline) recalls, a decrease in the performance time of TMTB (from 112.6±42.5 to 90.4±28.4 sec; p=0.02) and Stroop test Part 3 (from 135.5±50.1 to 112.6±19.6 sec; p=0.02), and a larger number of called words in the categorical associations test (from 6.5±2.4 to 8.1±2.9 words; p=0.02). Conclusion. The results obtained indicate that in treatment-naive middle-aged patients with EAH, indapamide/perindopril fixed-dose combination assures an effective reduction in BPs, as evidenced by routine measurements and ABPM, also improves cognitive functions, particularly attention, information processing speed, semantic memory, cognitive flexibility, and short-term and long-term memory.

scholarly journals Risk factors for cardiovascular complications in patients with left breast cancer in daily clinical practice

2020 ◽  
Vol 12 (2) ◽  
pp. 63-70
Author(s):  
Elena G. Poroshina ◽  
Irina V. Vologdina ◽  
Razifa M. Zhabina ◽  
Andrey A. Stanzhevsky ◽  
Larisa A. Krasilnikova
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Risk Factors ◽  
Elderly Patients ◽  
Healthy Lifestyle ◽  
The Elderly ◽  
Cardiovascular Complications ◽  
Left Breast ◽  
Middle Aged ◽  
Aged Patients

Purpose. Detection of adherence to a healthy lifestyle (HLS) and evaluation of behavioral risk factors for cardiovascular complications (CVC), including psychosocial, in patients with left breast cancer at the stage of chemoradiotherapy in daily clinical practice. Materials and methods. The patients were hospitalized for 3D conformal radiation therapy on the bed of the left breast with a total radiation dose (TRD) of 39 Gy (equivalent to 48 Gy of conventional fractionation). All the patients had a Madden mastectomy at the previous stages followed by doxorubicin therapy at a cumulative dose not exceeding 360 mg/m2. Determination of all components of a healthy lifestyle was carried out according to the data of interviewing the participants. The risk category of cardiovascular complications was assessed according to the SCORE scale. Additional characteristics including psychosocial factors were assessed. The examination included ECG and echocardiography. Results. At the initial examination, 58% of middle-aged patients and 74% of elderly patients showed comorbidity, while 18% of middle-aged patients and 29% of elderly patients had multiple comorbidities. Low adherence to healthy lifestyle in the patients was primarily associated with low physical activity due to the existing pain syndrome caused by both the tumor process itself and the surgical intervention. Physical activity in both groups was significantly lower than in the general population. High risk of CVC was significantly more common in the elderly patients. Systolic and diastolic dysfunction as a manifestation of cardiotoxicity after the previous stage of doxorubicin therapy were detected in middle-aged patients in 35.7% of the cases, in the elderly patients in 56.5% of the cases (HR 0.643, 95% CI 0.470-0.880). Psychosocial factors such as acute chronic stress and family problems were the most common. All the examined patients showed moderate reactive anxiety. The elderly patients showed a high level of personal anxiety. Conclusions. The obtained data suggest that in breast cancer patients, low adherence to HLS is primarily associated with low physical activity and unhealthy diet and to a much lesser extent smoking, which is of great importance in the formation of a healthy lifestyle in these patients in the future. In elderly patients, the study significantly more often identified risk factors such as obesity, high blood pressure, hypercholesterolemia and hyperglycemia. These patients revealed increased level of personal anxiety. This highlights the need for an expanded study of not only the main but also additional risk factors.

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