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巴西社区老年人血压特征对虚弱表型的影响 - FIBRA 研究。

Influence of blood pressure profile on frailty phenotype in community-dwelling elders in Brazil - FIBRA study.

机构信息

Faculty of Medical Sciences, Campinas State University, Unicamp, Brazil.

出版信息

Arch Gerontol Geriatr. 2013 Mar-Apr;56(2):343-9. doi: 10.1016/j.archger.2012.08.004. Epub 2012 Aug 28.

Abstract

Frailty is a clinical condition associated with pathological aging and biological vulnerability. In the spectrum of events related to frailty, aging of the cardiocirculatory system and abnormalities in arterial blood pressure (BP) partly explain the changes in tissue perfusion and, potentially, the decrease in physiological reserves. This study investigated the relationship between BP levels, systemic arterial hypertension (SAH) and the frailty phenotype by analyzing frailty criteria in a cross-sectional model into the FIBRA network, a populational sample of community-dwelling elders in Southeastern Brazil. Study participants with ≥65 years were selected by probabilistic sampling of residents in the urban area of the municipality of Campinas (n=900). Considering frailty as a whole and the difference between genders, there was a greater proportion of frail or pre-frail individuals among women than men. Analysis of individual frailty criteria showed that weight loss and fatigue were more common among women (18.3% vs. 12.5%, p=0.034 and 22.5% vs. 11.9%, p<0.001, respectively). Comparison of individuals with or without SAH failed to reveal any differences related to frailty criteria. Nevertheless, averages of diastolic blood pressure (DBP) and mean arterial blood pressure values were lower among elderly individuals with reduced grip strength, physical activity and the frailty classification as a whole (OR 0.986, IC 0.975-0.997) (for every 1 mmHg reduction in MBP values, the likelihood of being frail increased 1.4%). Our findings corroborate the relationship between BP values and frailty in the elderly and contribute to an understanding of the pathophysiological mechanisms of the syndrome.

摘要

衰弱是一种与病理性衰老和生物脆弱性相关的临床病症。在与衰弱相关的一系列事件中,心血管系统的衰老和动脉血压(BP)异常部分解释了组织灌注的变化,并可能导致生理储备的减少。本研究通过分析 FIBRA 网络中横断面模型中的衰弱标准,调查了 BP 水平、系统性动脉高血压(SAH)与衰弱表型之间的关系,该网络是巴西东南部社区居住老年人的人口样本。通过概率抽样选择了≥65 岁的研究参与者,这些参与者来自坎皮纳斯市(n=900)城区的居民。考虑到衰弱作为一个整体以及性别差异,女性中衰弱或虚弱前期的比例高于男性。对个体衰弱标准的分析表明,体重减轻和疲劳在女性中更为常见(18.3%对 12.5%,p=0.034 和 22.5%对 11.9%,p<0.001)。比较有或没有 SAH 的个体,未能发现与衰弱标准相关的差异。然而,握力下降、体力活动减少以及衰弱整体分类的老年人中,舒张压(DBP)和平均动脉血压值的平均值较低(OR 0.986,IC 0.975-0.997)(MBP 值每降低 1mmHg,衰弱的可能性增加 1.4%)。我们的研究结果证实了 BP 值与老年人衰弱之间的关系,并有助于理解该综合征的病理生理机制。

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