浙江医学2017，Vol.39Issue(6)：421-424,427,5.DOI:10.12056/j.issn.1006-2785.2017.39.6.2017-433
老年综合评估在老年高血压患者中的应用
Application of comprehensive geriatric assessment in elderly hypertensive patients
摘要
Abstract
Objective To assess the application of comprehensive geriatric assessment (CGA) in elderly hypertensive patients.Methods A total of 457 elderly hypertensive patients aged 65 years or above were admitted,and the associations of hypertension-related parameters,including durations,stages,blood pressure control and pulse pressure (PP),with geriatric syndromes were analyzed.Results The median of geriatric syndromes was 4.0(2.5-5.0) in hypertensive patients.Among these patients,the prevalence of orthostatic hypotension(OH),comorbidities(≥5 diseases),polypharmacy (≥5 drugs),Modified Barthel Index(MBI) ≤95,Min-Mental State Examination (MMSE)≤24,15-item Geriatric Depression Scale (GDS-15) ≥6,Mini Nutritional Assessment Short Form (MNA-SF) ≤11,Tinetti Performance Oriented Mobility Assessment (POMA)≤24,hearing and visual impairment was 19.7％,69.4％,55.8％,39.2％,28.7％,14.7％,23.0％,43.1％,49.5％ and 53.0％,respectively.Patients with ＞ 10 years durations had higher percentage of comorbidities than those with ≤ 10 years duration (P＜0.05).There were significantly differences in the incidences of OH,GDS-15 ≥6 and hearing impairment in patients with different hypertension grades (all P＜ 0.05).The incidence of OH was lower in well-controlled hypertension patients than that of poorly-controlled hypertensive patients (P＜0.05).Compared with patients with PP＞60mmHg,those with PP ≤ 60mmHg had lower incidence of OH,polypharmacy,MBI ≤ 95,MMSE ≤24 and hearing impairment (all P＜0.05).Conclusion The elderly hypertensive patients have higher incidence of geriatric syndromes.Patients with longer durations are more prone to have comorbidities.Poorly-controlled hypertension patients are at greater risk of OH.Furthermore,the incidence of OH,decreased activities of daily living,cognitive decline and hearing impairment is associated with PP ＞60mmHg in hypertensive patients.Therefore,early application of CGA may guide clinical practice to improve the quality of life in elderly hypertensive patients.关键词
老年综合评估/高血压/应用Key words
Comprehensive geriatric assessment/Hypertension/Application引用本文复制引用
卢佩颖,沈珊珊,陈旭娇..老年综合评估在老年高血压患者中的应用[J].浙江医学,2017,39(6):421-424,427,5.基金项目
国家卫生和计划生育委员会科研基金项目(WKJ2013-2-001) （WKJ2013-2-001）
2015浙江省医学重点创新学科(老年逆龄医学)项目 （老年逆龄医学）
2017年浙江省医药卫生科技项目(2017KY174) （2017KY174）
