Effect Of Blood Pressure Level On Cognitive Function And Daily Life Ability In The Very Elderly Hypertensive Patients

Objective:Study of the cognitive function and the ability of daily life status in the very elderly hypertensive patients and the effect of blood pressure levels on cognitive function and ability of daily life. Provide the evidence for clinical intervention measures.Methods:We randomly assigned120patients from the Second Xiangya Hospital who were80years of age or older. The number of male was72, female48. Aged from81to100years old with an average age85.2±3.8years old. The average SBP was142.6±19.6mm Hg and DBP76.5±11.0mm Hg. The object is divided into group A(SBP>150mm Hg, DBP<110mm Hg), group B (130mm Hg<SBP≤150mm Hg,DBP <110mm Hg) and group C (SBP≤130mm Hg, DBP<110mm Hg) according to the blood pressure level. To evaluate the daily living ability and cognitive function of research object by the ability of daily living scale (ADL) and mini-mental state examination (MMSE). To collect the patients' general information and clinical laboratory data for comparison. Use SPSS19.0for statistics analysis.Results:1Comparison of basic characteristics:There was no significant difference among3groups except SBP, DBP and PP (P<0.05)2Drug use condition:In all the selected object,30persons has taken CCB as antihypertensive medicine.24patients has taken CCB+ACEI/ARB,23patients has taken ACEI/ARB,11patients has taken ACEI/ARB+diuretic+CCB,7patients has taken ACEI/ARB+diuretic,3patients has taken CCB+diuretics,3patients has taken CCB+beta blocker,16patients has not regularly taken antihypertensive medicine.3Comparison of biochemical and ABI, c-fPWV and TCD:The. TC level of group A and B are significantly higher than that in group C (P<0.05), but there were no significant difference between group A and group B; UACR, ABI, TCD and c-fPWV of group A is significantly higher than that in group B and C(P<0.05), but there were no significant difference between group B and C (P>0.05)4In all the selected120patients,56persons had MCI, accounting for46.67%of the total numberand88people had a decrease in ADL, accounting for73.33%. There was no significant difference among3groups in ADL. Group B had significantly higher MMSE score than group A, C, and there was no statistical significance between group A, C.5Comparison between normal cognition group and impaired cognition group:Univariant correlation analysis between the two groups showed that significant difference existed in age, marital status, smoking, history of cerebrovascular disease, diabetes mellitus, ABI, SBP, PP,UACR and LDH CFPWV and TCD (P<0.05).6Multiple logistic regression analysis demonstrated that only age, PP, TCD and history of cerebrovascular disease were related to cognitive impairment.7Comparison between normal ADL group and impaired ADL group: Univariant correlation analysis between the two groups showed that significant difference existed in age, smoking, diabetes mellitus, ABI, CFPWV TCD and MMSE(P<0.05).8Multiple logistic regression analysis demonstrated that only age, diabetes mellitus and ABI were related to ADL impairment.Conclusion:1The level of blood pressure is related to cognitive function in the very elderly hypertensive patients. Pulse pressure, age, history of cerebrovascular disease, cerebral blood flow and24hour urinary albumin is the independent risk factors of cognitive function. We Should contral the level of blood pressure in order to maintain and improve the cognitive function in the very elderly hypertensive patients.2The level of blood pressure do not affect the ability of daily life directl. Age, diabetes, ABI are independent risk factors of ADL...