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Hypertension in the elderly is associated with increased occurrence rates of sodium sensitivity, isolated systolic hypertension, and 'white coat effect'. Arterial stiffness and endothelial dysfunction also increase with age. These factors should be considered in selecting antihypertensive therapy. The prime objective of this therapy is to prevent s...
Context in source publication
Context 1
... mentioned above, the condition of 'white coat hypertension' is more common in the elderly, and is often initially mistaken for ISH (see Table 3). In anticipation of a blood pressure measurement, the patient may become aware of this condition through a feeling of anxiety and an increased consciousness ...
Citations
... 1 AH involves a complex interaction of factors, including age and lifestyle. 2 This condition is highly prevalent among older people, 3,4 owing to its association with vascular aging. 5 As a result, the aging population is more vulnerable to fatal and non-fatal strokes, with consequent sequelae and impairment in the quality of life of individuals and their families. ...
... 13 Meditation as a technique for stress management can also help prevent or delay the onset of hypertension, and reduce BP levels in hypertensive individuals. 4,7,14 In particular, clinical studies have shown peripheral vasodilation during meditation, which could explain the benefits of decreased BP levels. 15 Furthermore, these benefits might be more effective and lasting when compared with other strategies, such as health education and progressive muscle relaxation. ...
... cardiovascular, circulatory and central nervous system), and psychological and environmental factors. 2 Furthermore, changes in the circulatory system, including artery stiffness, endothelial dysfunction, increased sensitivity to sodium, changes in baroreceptor sensitivity and others, make hypertension more difficult to control in the elderly. 4,5 The effects of meditation involve several mechanisms, including physiological and hormonal changes that can be observed after 8 days of intensive practice. These changes also illustrate the interaction between meditation practice and the activation of brain areas related to the relaxation response, which involves changes in the tone of the autonomic nervous system, and increased parasympathetic activity associated with low heart and respiratory rates. ...
... 1 AH involves a complex interaction of factors, including age and lifestyle. 2 This condition is highly prevalent among older people, 3,4 owing to its association with vascular aging. 5 As a result, the aging population is more vulnerable to fatal and non-fatal strokes, with consequent sequelae and impairment in the quality of life of individuals and their families. ...
... 13 Meditation as a technique for stress management can also help prevent or delay the onset of hypertension, and reduce BP levels in hypertensive individuals. 4,7,14 In particular, clinical studies have shown peripheral vasodilation during meditation, which could explain the benefits of decreased BP levels. 15 Furthermore, these benefits might be more effective and lasting when compared with other strategies, such as health education and progressive muscle relaxation. ...
... cardiovascular, circulatory and central nervous system), and psychological and environmental factors. 2 Furthermore, changes in the circulatory system, including artery stiffness, endothelial dysfunction, increased sensitivity to sodium, changes in baroreceptor sensitivity and others, make hypertension more difficult to control in the elderly. 4,5 The effects of meditation involve several mechanisms, including physiological and hormonal changes that can be observed after 8 days of intensive practice. These changes also illustrate the interaction between meditation practice and the activation of brain areas related to the relaxation response, which involves changes in the tone of the autonomic nervous system, and increased parasympathetic activity associated with low heart and respiratory rates. ...
... 1 AH involves a complex interaction of factors, including age and lifestyle. 2 This condition is highly prevalent among older people, 3,4 owing to its association with vascular aging. 5 As a result, the aging population is more vulnerable to fatal and non-fatal strokes, with consequent sequelae and impairment in the quality of life of individuals and their families. ...
... 13 Meditation as a technique for stress management can also help prevent or delay the onset of hypertension, and reduce BP levels in hypertensive individuals. 4,7,14 In particular, clinical studies have shown peripheral vasodilation during meditation, which could explain the benefits of decreased BP levels. 15 Furthermore, these benefits might be more effective and lasting when compared with other strategies, such as health education and progressive muscle relaxation. ...
... cardiovascular, circulatory and central nervous system), and psychological and environmental factors. 2 Furthermore, changes in the circulatory system, including artery stiffness, endothelial dysfunction, increased sensitivity to sodium, changes in baroreceptor sensitivity and others, make hypertension more difficult to control in the elderly. 4,5 The effects of meditation involve several mechanisms, including physiological and hormonal changes that can be observed after 8 days of intensive practice. These changes also illustrate the interaction between meditation practice and the activation of brain areas related to the relaxation response, which involves changes in the tone of the autonomic nervous system, and increased parasympathetic activity associated with low heart and respiratory rates. ...
Abstract
AIM:
The present study aimed to evaluate the effects of Zen meditation on blood pressure (BP) and quality of life in elderly subjects.
METHODS:
A total of 59 volunteers (21 men and 38 women), aged ≥60 years with systolic BP between 130 and 159 mmHg and diastolic BP between 85 and 99 mmHg, were randomly divided into a meditation group (MG), n = 28 and a control group (CG), n = 31. The MG meditated twice a day for 20 min for 3 months, and the CG remained on a waiting list. The BP levels were measured monthly in both groups. The volunteers' medication was kept stable. A quality of life assessment instrument was applied at the beginning and end of the study.
RESULTS:
For systolic BP, analysis of variance showed the influence of time (F(4,228) = 4.74, P < 0.01, β = 0.98) and the interaction group × time (F(4,228) = 3.07, P < 0.01, β = 0.89). The MG showed a significant decrease in systolic BP levels in the second measurement after 1 month of meditation practice when compared with the CG (Newman-Keuls test, P < 0.05). Starting at the second measurement, systolic BP levels in the MG were lower than the baseline and first measurement levels; however, the systolic BP levels were similar to those observed in the CG. In the quality of life assessment evaluation, a significant improvement in psychological aspects and overall quality of life in the MG compared with the CG was observed.
CONCLUSION:
These results suggest that Zen meditation is an interesting tool as a complementary treatment for hypertension in elderly subjects.
... 에서 나트륨 일일 섭취량이 많은 군이 적게 섭취하는 군 에 비해 고혈압의 위험도가 3.23배 증가되었다(Moon & Joung, 1999)는 보고는 본 연구결과를 지지한다. Stokes(2009) ...
Purpose: This study aimed to examine the compliance to a low-salt diet, sodium intake, and preferred salty taste in elderly patients with hypertension. Methods: A cross-sectional descriptive design was used. Participants were 105 elderly patients with hypertension living in a rural area. The compliance with a low-salt diet, sodium intake, and preferred salty taste, blood pressure, body mass index, and waist circumference were measured, and compared according to the general characteristics and the levels of blood pressure. Descriptive statistics, -test, t-test, and ANOVA were used for data analysis. Results: compliance with a low-salt diet was marginally elevated. Sodium intake was relatively high and the main sources were seasonings and vegetables. The participants tended to prefer high levels of salt. Sodium intake was significantly higher the hypertensive individuals (stage I and II) compared to prehypertensive subjects on a normal maintenance diet. Sodium intake from vegetables was also significantly different between the two groups. Conclusion: Nursing intervention for hypertensive elderly patients should include strategies to decrease sodium intake.
As other developing countries, Algeria knows an important increase of cardiovascular diseases resulting from a fast epidemiologic transition. Hypertension is a major risk factor for morbidity and mortality among these cardiovascular diseases. The objectives of the present survey were (i) to estimate the prevalence of hypertension and other cardio vascular risk factors in a sample of adults of EL-Menia oasis in Algerian Sahara and (ii) to study a possible association between hypertension and dietary habits, especially salt intake. Contrary to others oasis of Sahara, El-Menia was characterized by low sodium content in drinking water.
We performed a cross-sectional survey. Subjects were selected from people aged 40 years or older by stratified random cluster sampling. Blood pressure (BP) was measured at 3 times on one occasion according to standardized and validated procedures. A case of hypertension was defined as subjects used antihypertensive medication, or as a systolic BP ≥ 140 mm Hg and/or a diastolic BP ≥ 90 mm Hg in the average of the last 2 measures. The blood samples were collected: fasting plasma glucose, total cholesterol, triglycerides and, HDL cholesterol were measured. A questionnaire has been completed by physicians and anthropometric data were recorded for each included subject. Prevalence was expressed on percentage. A Khi-square test was performed to test differences of proportion of multiple variables, and Student’s t-test was performed to evaluate the difference between the mean of two variables. Multiple logistic regression analysis was used to assess significant association between different risk factors to hypertension. P values < 0.05 were regarded as statistically significant.
727 adults were included: 67% are female and 17, 7 % are black subjects. The mean age was 58.5 ± 13.2 years. The prevalence of hypertension was 50.2% (365/727): 51,3% (123/240) of male vs. 49.7% (242/487) of female, without significant differences between genders. Prevalence was significantly higher in black: 62% (80/129) than whites: 47, 9% (285/593), (p<0, 01). Among the 365 subjects diagnosed with hypertension, 58% were not aware of their status. Women and subjects aged of 60 and more years old were more aware of their hypertension than others. The control rate was 20% among 147 (95%) treated hypertensive.
Controlled BP was defined as, a systolic BP<140 mm Hg and a diastolic BP<90 mm Hg. There was no association between diet and hypertension in our population.
Using multivariate analysis, there was a significant relationship between hypertension and age (OR= 1, 52; CI 95 % = [1.40–1, 65]), skin colour (OR= 2, 23; CI 95 % = [1.39–3,58]),glycaemia (OR= 1,49; CI 95 % = ([1.21 –1,83]) and waist circumference (OR= 1,11; CI 95 % = [1.03–1,19]).
Our finding prevalence of arterial hypertension was similar to other age matched studies conducted in north Algeria and worldwide. Our finding prevalence was also similar to another study conducted in other oasis in the Algerian Sahara where the drinking water was characterized by high sodium content. Then, high sodium consumption seems not to be very important in the development of arterial hypertension in these regions. The high prevalence of hypertension shows the need for a model of health care capable of comprehending and integrating effective control and prevention actions.
Keywords: Prevalence, Hypertension, Cardiovascular risk factors, Prevention, Control, Diet habits, Salt intake.
This study aimed to determine whether different systolic blood pressure (SBP) measurements achieved with antihypertensive therapy impact clinical outcomes by age in patients with hypertension and coronary artery disease (CAD). This post hoc analysis from the Heart Institute of Japan Candesartan Randomized Trial for Evaluation in Coronary Heart Disease (HIJ‐CREATE) trial included 2048 patients with hypertension and angiographically documented CAD. Participants were divided into three groups based on age at enrollment: middle‐aged (<60 years, n = 570), pre‐elderly (≥60‐<70 years, n = 730), and elderly (≥70 years, n = 748). Among the 2,048 patients, 1695 (82.7%) underwent percutaneous coronary intervention. The primary end point was the time to first occurrence of a major adverse cardiac event (MACE). During a median follow‐up of 4.2 years, the MACE rate was 19.8%, 28.1%, and 31.1% in the middle‐aged, pre‐elderly, and elderly groups, respectively. Achieved BP was defined as the mean BP during scheduled visits. Patients with higher achieved SBP had a higher occurrence of MACE in all age groups. An unadjusted quadratic proportional hazard model was used to evaluate the relationship between achieved BP during follow‐up and risk for MACE. In each age group, participants were divided into quartiles based on the achieved BP during follow‐up. The relationship between achieved SBP and the incidence of MACE did not follow a J‐shaped curve in any age group. In conclusion, in the contemporary era of aggressive coronary revascularization, a lower SBP target may be appropriate even in elderly patients with hypertension and CAD.
Background:
The aim of the present study was to determine the effectiveness of a self-care education (SCE) discharge program with telephone follow-ups in managing hypertension (HTN) in older patients.
Methods:
The study was conducted on 56 older patients with HTN who had recently been discharged from the cardiac wards of hospitals in Isfahan, Iran, in 2017. Participants were randomly allocated to the intervention and control groups. The intervention was a 60-minute SCE discharge program with 4 re-educative telephone follow-ups every 2 weeks based on 4 chapters of the designed SCE program and booklet. After coding the data and entering them into SPSS software, data were analyzed for the comparison of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) as well as frequency of managed HTN in the intervention and control groups at baseline (before discharge), and 2 and 3 months after discharge.
Results:
Statistical tests showed no significant difference in any of the demographic and confounding variables as well as baseline BPs (P > 0.050), but at post-intervention follow-ups, after Mauchly's sphericity test, repeated measurements ANOVA showed that the effect of time (P < 0.001) and group (P = 0.043) on SBP was significant. The effect of time (P = 0.036) and group (P = 0.047) on DBP was also significant. McNemar's test showed that the frequency of managed HTN (normal BP), 3 months after discharge, was significantly higher in the intervention group compared to the control group [87.5% (n = 21) vs. 23.1% (n = 6), respectively] (P < 0.001).
Conclusion:
SCE discharge program with telephone re-educative follow-ups was effective in reducing mean BP. The use of this program as a discharged plan for older adults with HTN and comparison of readmission rates for a longer period are recommended.
Background:
Hypertension is one of the most important risk factors for cardiovascular disease, which contributes to lowering the quality of life (QOL), especially in elderly patients. Recent data show that almost half of the hypertensive patients and one-third of patients with comorbidities were nonadherent to medication.
Objective:
To assess the association of QOL with the level of adherence and to examine the association with selected variables on the level of adherence.
Design:
A prospective, cross-sectional, and analytical study.
Methods:
This study involved 186 hypertensive elderly patients (mean age: 71.05±7.47 years). An analysis of medical records based on sociodemographic and clinical data was conducted. The World Health Organization Quality of Life Scale Brief version (WHOQOL-BREF) was used to assess the level of QOL, and the Hill-Bone Compliance to High Blood Pressure Therapy Scale (HBQ) was used to examine the level of adherence to therapeutic recommendations in hypertensive patients.
Results:
The average assessment of the QOL measured by the WHOQOL-BREF questionnaire was 3.36±0.84 points, which indicates a QOL at a level between average and good. The patients' average score on the HBQ questionnaire was 20.39±4.31 points. In the "reduced sodium intake" subscale, patients had an average of 4.75±1.33 points. In the "appointment keeping" subscale, the patients scored an average of 3.45±1.07 points. In the "medication taking" subscale, the patients had an average of 12.19±3.46 points. It was shown that the total score of the HBQ questionnaire was negatively correlated with all domains of QOL assessed with the WHOQOL-BREF questionnaire (P<0.05).
Conclusion:
There is an association between QOL and adherence to therapeutic recommendations among hypertensive elderly patients. It has been concluded that with an increasing QOL, the level of adherence to therapeutic recommendations increases. The level of adherence is also negatively affected by: older age, longer duration of disease, worse marital status, lower education, living alone, and using polytherapy.
