| Objective In the elderly patients with essential hypertension,the Comprehensive Geriatric Asessment(CGA)is used to evaluate and intervene in various aspects such as physical function,neuropsychiatric state,disease,medication management,and social environment.To study the role of CGA in controlling blood pressure,ambulatory blood pressure and blood pressure variability in the comprehensive treatment of elderly hypertensive patients,thereby delaying the target organ damage of hypertension and improving the quality of life of elderly patients.Methods The clinical data of elderly hypertensive patients who were hospitalized from June 2016 to June 2017 were collected in the Department of Geriatrics,First People’s Hospital of Hefei(The Third Affiliated Hospital of Anhui Medical University).122 elderly patients who met the inclusion criteria were selected.Inclusion criteria: 1)age ≥ 65 years;2)consent and signing informed consent;3)no recent acute cardiovascular and cerebrovascular events;4)no uncontrolled malignancy;5)no single or multiple organ failure;6)All patients with hypertension meet the diagnostic criteria for essential hypertension prescribed in the 2010 Guidelines for the Prevention and Treatment of Hypertension in China.The subjects were randomly divided into the experimental group of 61 cases and the control group of 61 cases.Before starting CGA,general information of the two groups of patients,including age,gender,duration of hypertension,etc.,were measured,and the patient’s even blood pressure,24-hour ambulatory blood pressure,blood pressure standard deviation,and coefficient of variation were measured and recorded.The experimental group conducted a comprehensive evaluation of the elderly at the same time as the oral treatment of antihypertensive drugs.The comprehensive evaluation of the elderly was generally completed within 3 days after admission,and then the corresponding interventions were implemented according to the results of the evaluation;The intervention time was 3months,and the comprehensive evaluation of the elderly was performed again after the intervention.The control group only received medication and general life guidance.Finally,the blood pressure,24-hour ambulatory blood pressure,24-hour blood pressure standard deviation and variability of the two groups were monitored.The changes of blood pressure before and after treatment were compared and analyzed.All data were analyzed by SPSS 17.0 software.The independent sample t test was used for comparison between the two groups.P<0.05 was considered statistically significant.Results 1There were no significant differences in gender,age,and duration of hypertension between the two groups(P>0.05).2In the casual blood pressure,the systolic and diastolic blood pressures of the experimental group and the control group were lower than those before the treatment,and the difference was statistically significant(132.720±10.526/69.280±6.491 mm Hg,147.210±8.849/69.610±4.631 mm Hgvs165.540±9.275/82.460±8.869 mm Hg,164.260±8.991/81.920±9.740 mm Hg,P<0.01);and the experimental group had a more pronounced decrease in systolic blood pressure(P<0.01).3Among the 24 h ambulatory blood pressure,the difference of systolic blood pressure and diastolic blood pressure between the two groups was statistically significant compared with that before treatment(131.570±10.140/69.050±6.040 mm Hg,144.300±8.688/70.510±4.884 mm Hgvs161.330±10.102/80.840±7.862 mm Hg,161.280±8.922/80.100±7.726 mm Hg,P<0.01];and the test group’s 24 h systolic blood pressure decreased more significantly(P<0.01).4After treatment,the two groups of blood pressure variability were lower than those before treatment(P<0.01),and the decrease in the experimental group was more obvious(P<0.05).Conclusion Comprehensive geriatric assessment can improve or maintain quality of life of elderly patients with hypertension,which optimized the treatment effect. |
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