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

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.

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