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老年高血压患者衰弱综合征评估及对建议的依从性

Evaluation of Frailty Syndrome and Adherence to Recommendations in Elderly Patients with Hypertension.

作者信息

Pobrotyn Piotr, Pasieczna Aleksandra, Diakowska Dorota, Uchmanowicz Bartosz, Mazur Grzegorz, Banasik Mirosław, Kołtuniuk Aleksandra

机构信息

University Clinical Hospital in Wroclaw, 50-529 Wroclaw, Poland.

Department of Finance and Accounting, Kozminski University, 03-301 Warsaw, Poland.

出版信息

J Clin Med. 2021 Aug 24;10(17):3771. doi: 10.3390/jcm10173771.

Abstract

Frailty syndrome (FS) often coexists with many diseases of the elderly, including arterial hypertension, and may affect the disease course and adherence to therapeutic recommendations. This study aimed to evaluate the relationship between frailty and adherence to therapeutic recommendations in elderly hypertensive patients. The study included 259 patients hospitalized between January 2019 and November 2020 due to exacerbation of hypertension symptoms. Medical records were used to obtain basic sociodemographic and clinical data. The study was based on the Tilburg Frailty Indicator (TFI) and the Hill-Bone Scale (HBCS). The obtained data were analyzed within a cross-sectional design. The mean frailty score indicated by the TFI questionnaire was 7.09 ± 3.73. The most prominent FS component was associated with the physical domain (4.24 ± 2.54). The mean overall adherence measured with the HBCS was 20.51 ± 3.72. The linear regression model testing the Hill-Bone "reduced sodium intake" score against the TFI domains showed no relationships between the variables. Another regression model for the Hill-Bone "appointment-keeping" subscale indicated significant predictors for physical and social TFI domains ( = 0.002 and < 0.0001, respectively). For the Hill-Bone "taking antihypertensive drugs" variable, the regression model found significant relationships with all TFI domains: physical ( < 0.0001), psychological ( = 0.003) and social ( < 0.0001). Our study suggests that frailty in patients with arterial hypertension can negatively impact their adherence to therapeutic recommendations.

摘要

衰弱综合征(FS)常与多种老年疾病并存,包括动脉高血压,并且可能影响疾病进程以及对治疗建议的依从性。本研究旨在评估老年高血压患者衰弱与对治疗建议依从性之间的关系。该研究纳入了259例在2019年1月至2020年11月期间因高血压症状加重而住院的患者。通过病历获取基本的社会人口学和临床数据。该研究基于蒂尔堡衰弱指标(TFI)和希尔 - 博恩量表(HBCS)。所获数据采用横断面设计进行分析。TFI问卷显示的平均衰弱评分为7.09±3.73。最突出的FS成分与身体领域相关(4.24±2.54)。用HBCS测量的平均总体依从性为20.51±3.72。针对希尔 - 博恩“减少钠摄入”得分与TFI各领域进行检验的线性回归模型显示变量之间无关联。针对希尔 - 博恩“按时就诊”子量表的另一个回归模型表明身体和社会TFI领域有显著预测因素(分别为 = 0.002和 < 0.0001)。对于希尔 - 博恩“服用降压药”变量,回归模型发现与所有TFI领域均存在显著关联:身体领域( < 0.0001)、心理领域( = 0.003)和社会领域( < 0.0001)。我们的研究表明,动脉高血压患者的衰弱会对其对治疗建议的依从性产生负面影响。

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Treatment adherence and frailty syndrome in hypertensive older adults.高血压老年患者的治疗依从性与衰弱综合征。
Rev Esc Enferm USP. 2020 Sep 21;54:e03590. doi: 10.1590/S1980-220X2018048903590. eCollection 2020.

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