Mildly elevated blood pressure is a marker for better health status in Polish centenarians.

The number of centenarians is projected to rise rapidly. However, knowledge of evidence-based health care in this group is still poor. Hypertension is the most common condition that leads to multiple organ complications, disability, and premature death. No guidelines for the management of high blood pressure (BP) in centenarians are available. We have performed a cross-sectional study to characterize clinical and functional state of Polish centenarians, with a special focus on BP. The study comprised 86 consecutive 100.9 ± 1.2 years old (mean ± SD) subjects (70 women and 16 men). The assessment included structured interview, physical examination, geriatric functional assessment, resting electrocardiography, and blood and urine sampling. The subjects were followed-up on the phone. Subjects who survived 180 days (83 %) as compared to non-survivors had higher systolic BP (SBP), diastolic BP (DPB), mean arterial pressure (MAP), pulse pressure (PP), higher mini-mental state examination, Barthel Index of Activities of Daily Living and Lawton Instrumental Activities of Daily Living Scale scores, higher serum albumin and calcium levels, and total iron-binding capacity, while lower serum creatinine, cystatin C, folate, and C-reactive protein levels. SBP ≥140 mm Hg, DBP ≥90 mm Hg, MAP ≥100 mm Hg, and PP ≥40 mm Hg were associated with higher 180-day survival probability. Results suggest that mildly elevated blood pressure is a marker for better health status in Polish centenarians.

[Clinical characteristics of 33 patients with adrenal incidentaloma]. / Analiza kliniczna 33 chorych z bezobjawowym guzem nadnerczy (incidentaloma).

UNLABELLED: Incidentally diagnosed, clinically asymptomatic adrenal masses (incidentaloma) have become more and more common problem in everyday clinical practice. The prevalence of such tumors is 2.3% in autopsy series and 0.5-2% in computed tomography series. The aim of the study was a clinical analysis of patients with adrenal incidentaloma, hospitalized in the Department of Internal and Metabolic Diseases of the Medical University of Silesia. MATERIAL AND METHODS: 33 patients, including 25 females (75.7%) and 8 males (24.3%), were investigated. The mean age was 59.0 +/- 10.7 year (31-80) and the mean body mass index (BMI) was 29.6 +/- 5.9 kg/m2 (19.4-47). RESULTS: 16 patients (48.5%) were obese and 10 more patients (30.3%) were overweight. Hypertension was diagnosed in 25 patients (75.8%), diabetes or impaired glucose tolerance in 9 patients (27.3%) and hyperlipidemia in 20 patients (60.6%). Endocrine tests revealed: disturbed cortisol rhythm in 1 patient, uncertain result of the overnight dexamethasone suppression test in 4 patients, elevated urinary 17-hydroxycorticosteroids excretion in 7 patients, elevated urinary 17-ketosteroids excretion in 2 patients and increased urinary excretion ofvanillylmandelic acid in 2 patients. The tumor was located in the right adrenal gland in 13 patients (39.4%) and in the left adrenal gland in 16 patients (48.5%). 4 patients (12.1%) demonstrated bilateral adrenal masses. At least one of the tumor sizes was greater than 40 mm in 3 patients (9.1%). CONCLUSION: Clinically asymptomatic adrenal tumors occurred more frequently in overweight or obese women, between 51-70 years old, with lipid disorders and hypertension.