Meyer Marco, Niemöller Ulrich, Arnold Andreas, Stein Thomas, Erkapic Damir, Schramm Patrick, Tanislav Christian
Department of Geriatrics, Diakonie Hospital Jung-Stilling Siegen, 57074 Siegen, Germany.
Department of Cardiology, Rhythmology and Angiology, Diakonie Hospital Jung-Stilling, 57074 Siegen, Germany.
Geriatrics (Basel). 2023 Feb 28;8(2):32. doi: 10.3390/geriatrics8020032.
Comprehensive geriatric care (CGC) is a multiprofessional treatment for older people which considers medical conditions and functional status. The aim of the presented study is to investigate the impact of hypertensive blood pressure (BP) on functional outcomes among older adults receiving CGC.
Functional status was documented by the Barthel index (BI), Tinetti test (TBGT), and timed up and go test (TUG) prior to and after CGC. The results were analyzed in relation to hypertensive BP, indicated by mean BP ≥ 130/80 mmHg determined by 24 h blood pressure monitoring (BPM) while hospitalized.
In the presented monocentric, retrospective, observational study, 490 patients were included (mean age (SD): 83.86 ± 6.17 years, 72.2% females). Hypertension in BPM was found in 302 (61.6%) individuals. Hypertensive BP was associated with the female sex ( < 0.001) and current fracture ( = 0.001), and inversely associated with heart failure ( < 0.001), coronary heart disease ( < 0.001), atrial fibrillation ( < 0.001), urinary tract infection ( = 0.022), and hypocalcemia ( = 0.014). After CGC, improvements in BI ( < 0.001), TBGT ( < 0.001), and TUG ( < 0.001) were observed in patients with both normotensive and hypertensive BP profiles. The proportion of patients with outcome improvements did not differ between the two groups (BI: 84.4% vs. 88.3%, = 0.285; TBGT: 81.1% vs. 77.7%, = 0.357; TUG: 50.3% vs. 48.4%, = 0.711).
Patients both with and without hypertensive BP profiles benefited from comprehensive geriatric care with comparable outcome improvements. Particularly, normotensive BP was associated with chronic cardiovascular comorbidities, indicating increased awareness of the importance of BP management in patients diagnosed with cardiac diseases.
综合老年护理（CGC）是一种针对老年人的多专业治疗方法，它兼顾医疗状况和功能状态。本研究的目的是调查高血压血压（BP）对接受CGC的老年人功能结局的影响。
在CGC前后，通过Barthel指数（BI）、Tinetti测试（TBGT）和计时起立行走测试（TUG）记录功能状态。根据住院期间24小时血压监测（BPM）测定的平均血压≥130/80 mmHg所表明的高血压BP，对结果进行分析。
在本单中心、回顾性、观察性研究中，纳入了490例患者（平均年龄（标准差）：83.86±6.17岁，72.2%为女性）。302例（61.6%）个体在BPM中发现高血压。高血压BP与女性（<0.001）和当前骨折（=0.001）相关，与心力衰竭（<0.001）、冠心病（<0.001）、心房颤动（<0.001）、尿路感染（=0.022）和低钙血症（=0.014）呈负相关。CGC后，血压正常和高血压BP患者的BI（<0.001）、TBGT（<0.001）和TUG（<0.001）均有改善。两组间结局改善患者的比例无差异（BI：84.4%对88.3%，=0.285；TBGT：81.1%对77.7%，=0.357；TUG：50.3%对48.4%，=0.711）。
有和没有高血压BP的患者均从综合老年护理中受益，结局改善相当。特别是，血压正常与慢性心血管合并症相关，表明对诊断为心脏病患者的血压管理重要性的认识有所提高。
