Ambulatory blood-pressure monitoring, antihypertensive therapy and the risk of fall injuries in elderly hypertensive patients

作     者：Michael Jonas Rasisa Kazarski Gil Chemin 

作者机构：Department of Cardiology Kaplan Medical Center Hebrew University School of Medicine Rehovot Israel Department of Nephrology and Hypertension Kaplan Medical Center Hebrew University School of Medicine Rehovot Israel 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2018年第15卷第4期

页      面：284-289页

核心收录：

学科分类：0710[理学-生物学] 0832[工学-食品科学与工程（可授工学、农学学位）] 07[理学] 08[工学] 083202[工学-粮食、油脂及植物蛋白工程] 071003[理学-生理学] 

主　　题：Ambulatory blood pressure monitoring Hypertension Falls 

摘      要：Background Fall injuries are common among the elderly. The aim of this study was to investigate whether blood-pressure patterns, as measured by 24-h ambulatory blood pressure monitoring （ABPM）, or intensification of antihypertensive therapy following the 24-h ABPM, may be associated with fall injuries in hypertensive elderly patients. Methods In a retrospective study, community-based elderly patients （age ≥ 70 years） who were referred to 24-h ABPM were evaluated for fall injuries within one-year post-ABPM. We compared the clinical characteristics, 24-h ABPM patterns and the intensification of hypertensive therapy following 24-h ABPM, between patients with and without a fall injury. Results Overall 1032 hypertensive elderly patients were evaluated. Fifty-five （5.3%） had a fall injury episode in the year following ABPM. Patients with a fall injury were significantly older, and with higher rates of previous falls. Lower 24-h diastolic blood-pressure （67.3 ± 7.6 vs. 70.7 ± 8.8 mmHg; P 〈 0.005） and increased pulse-pressure （74.7 ± 14.3 vs. 68.3 ± 13.7 mmHg; P 〈 0.005）, were found in the patients with a fall injury, compared to those without a fall injury. After adjustment for age, gender, diabetes mellitus and previous falls, lower diastolic blood-pressure and increased pulse-pressure were independent predictors of fall injury. Intensification of antihypertensive treatment following the 24-h ABPM was not associated with an increased rate of fall injury. Conclusions Low diastolic blood-pressure and increased pulse-pressure in 24-h ABPM were associated with an increased risk of fall injury in elderly hypertensive patients. Intensification of antihypertensive treatment following 24-h ABPM was not associated with an increased risk of fall injury.