Ugwu C N, Okafor C I, Ejim E C, Ugwu N I, Chika-Igwenyi N M, Obeka N, Ikeagwulonu R C, Iyidobi T C, Nnadozie U U, Afolabi F O, Kalu A U, Isiguzo G C
Department of Internal Medicine, Faculty of Clinical Medicine, College of Health Sciences, Ebonyi State University, Abakaliki, Nigeria.
Department of Medicine, Faculty of Medical Sciences, University of Nigeria, Ituku-Ozalla Campus, Enugu State, Nigeria.
West Afr J Med. 2022 Nov 30;39(11):1141-1147.
The elderly hypertensive patients often have increased prevalence of cardiometabolic risk factors and their attendant co-morbidities. The aim of this study was to determine the prevalence of cardiometabolic risk factors and blood pressure control among elderly hypertensive patients, and to determine the influence of modifiable cardiometabolic risk factors on the control of hypertension among elderly hypertensive patients.
A case-control comparative and hospitalbased study involving a total of 190 consenting elderly (>65 years), hypertensive patients (subjects) (n=100) and normotensive controls (n=90) was carried out over a period of ten months. Using interviewer-administered questionnaire, biodata and information regarding their lifestyle was obtained. Standard protocols were used to measure blood pressure, weight, height, waist circumference, fasting plasma glucose and fasting lipid profile of the subjects. Body mass index was derived from weight and height.
The mean age of the subjects was 71.5 ± 6.3 years and the controls was 72.3 ± 7.2 years. Forty-eight percent (48%) and 47.8% of the subjects and controls were females (p = 0.651). The level of control of hypertension was poor in over two-thirds (68%) of the elderly hypertensive patients. The prevalence of modifiable cardiometabolic risk factors burden was higher in the hypertensive subjects when compared with the controls. Prevalence of Dyslipidaemia was 76% in the subjects and 51% in the controls (p = 0.004). Prevalence of Diabetes Mellitus was 40% among the subjects and 17.8% in the controls (p = 0.0001); prevalence of Obesity was 24% in the subjects and 4.4% in the controls (p=<0.001); prevalence of excess alcohol intake was 49% in the subjects and 14.4% in the controls (p=<0.001). Prevalence of sedentary life style was high in both the subjects (53%) and controls (50%), p=0.679. Poor blood pressure control was predicted by dyslipidaemia and central obesity.
The level of control of hypertension was poor among the elderly and modifiable cardiometabolic risk factors were relatively prevalent. Central obesity and dyslipidaemia were predictive of poor control of hypertension. Addressing these factors may therefore improve blood pressure control.
老年高血压患者常伴有心血管代谢危险因素及其相关合并症的患病率增加。本研究的目的是确定老年高血压患者心血管代谢危险因素的患病率及血压控制情况，并确定可改变的心血管代谢危险因素对老年高血压患者高血压控制的影响。
一项病例对照比较研究，基于医院进行，共纳入190名同意参与的老年（>65岁）高血压患者（研究对象）（n = 100）和血压正常对照者（n = 90），研究持续了10个月。通过访谈问卷获取了研究对象的个人资料和生活方式信息。采用标准方案测量研究对象的血压、体重、身高、腰围、空腹血糖和空腹血脂谱。体重指数由体重和身高计算得出。
研究对象的平均年龄为71.5±6.3岁，对照者为72.3±7.2岁。研究对象和对照者中分别有48%和47.8%为女性（p = 0.651）。超过三分之二（68%）的老年高血压患者血压控制不佳。与对照者相比，高血压患者中可改变的心血管代谢危险因素负担患病率更高。血脂异常患病率在研究对象中为76%，对照者中为51%（p = 0.004）。糖尿病患病率在研究对象中为40%，对照者中为17.8%（p = 0.0001）；肥胖患病率在研究对象中为24%，对照者中为4.4%（p<0.001）；过量饮酒患病率在研究对象中为49%，对照者中为14.4%（p<0.001）。研究对象（53%）和对照者（50%）久坐生活方式的患病率均较高，p = 0.679。血脂异常和中心型肥胖可预测血压控制不佳。
老年人高血压控制水平较差，可改变的心血管代谢危险因素相对普遍。中心型肥胖和血脂异常可预测高血压控制不佳。因此，解决这些因素可能会改善血压控制。
