Evaluation of frequency of occurrence of cognitive impairment in the course of arterial hypertension in an elderly population.

BACKGROUND: Dementia is a very serious problem with regard to geriatric population. In the population over the age of 80 the prevalence of dementia varies by up to 20%. It is very important to answer the question - are arterial hypertension and its duration associated with cognitive performance? METHODS: One hundred and sixty people were qualified for participation in the study, women and men, diagnosed with arterial hypertension. The patients were divided into two pairs of groups. The first pair was group 1, patients with hypertension over the age of 85 and group 2, patients with hypertension aged 75-85. The second pair was group I, patients with up to 10 years of arterial hypertension and group II, patients with over 10 years of arterial hypertension. In the study, the Mini-Mental State Examination (MMSE) was used. Interpretation of impairment depended on the obtained numerical value. RESULTS: In the tested group of patients, for individual correlations it was found that age is the independent variable which significantly affects the MMSE score. It was found that the time of duration of arterial hypertension did not have impact on the MMSE. CONCLUSION: Cognitive functions evaluated through the MMSE were correct for the entire population. The length of the course of arterial hypertension did not have a significant adverse impact on cognitive functions and on the achieved MMSE result. Significant impact of age on the lowering of MMSE results and impairment of cognitive functions was shown.

[Evaluation of renal function in the course of hypertension in the elderly]. / Ocena funkcji nerek w przebiegu nadcisnienia tetniczego u osób w podeszlym wieku.

Hypertension is one of the most common chronic diseases in Poland. It occurs in all age groups, but most often affects people over 65 years of age. The correct diagnosis of hypertension in older people includes documenting elevated blood pressure values, differentiating disease changes from physiologically related changes to aging, as well as assessing organ related complications. Detection of organ complications is also an important parameter of prognosis assessment. AIM: The aim of the study was evaluation of renal function in the course of hypertension in the elderly. MATERIALS AND METHODS: The study involved 63 women and 17 men, aged from 75 to 93 years, who were diagnosed with arterial hypertension in accordance with the guidelines of the Polish Society of Hypertension. Patients were divided into two groups. The first pair consisted of a group of 1 hypertensive patients (HA) lasting up to 10 years of age over 85 years and a group of 2 patients with HA lasting up to 10 years at the age of 75-85 years. The second pair is group I - patients with HA over 10 years of age over 85 years and group II - patients with HA lasting over 10 years at the age of 75-85. The assessment of glomerular filtration was made using the estimated glomerular filtration rate (GFR), which was calculated according to the mathematical formula of MDRD, while the renal resistance index was assessed using spectral Doppler after visualization of the flow in the renal arteries. RESULTS: The value of glomerular filtration in the examined groups divided by age was 55.1±15 (group 1) and 66.9±16 (group 2). The values of the kidney artery resistance index (depending on age) were in 1 group: 0.61±0.04 vs 0.60±0.05 and in the second group: 0.59±0.06 vs 0.58±0.05. The values of the renal artery resistance index (depending on the duration of HA) were 0.62±0.04 vs 0.61±0.03 (group I) and 0.61±0.04 vs 0.60±0.04 ( group II). CONCLUSIONS: GFR depends on the duration of hypertension. A relationship was found between the value of the kidney artery resistance index and age. There was no significant relationship between the value of the kidney artery resistance index and duration of hypertension.

[Evaluation of the incidence of stroke in the course of hypertension in elderly patients]. / Ocena czestosci wystepowania udaru mózgu w przebiegu nadcisnienia tetniczego u chorych w podeszlym wieku.

One of the more common chronic diseases is hypertension. After 70 years of age, it is found in over 70% of this population. It causes a number of organ complications that cause death. AIM: The aim of the study was to evaluate the prevalence of stroke in hypertension in elderly patients. MATERIALS AND METHODS: The study involved 63 women and 17 men, aged from 75 to 93 years, who were diagnosed with arterial hypertension in accordance with the guidelines of the Polish Society of Hypertension. Patients were divided into two groups. The first pair consisted of a group of 1 hypertensive patients (HA) lasting up to 10 years of age over 85 years and a group of 2 patients with HA lasting up to 10 years at the age of 75-85 years. The second pair is group I - patients with HA over 10 years of age over 85 years and group II - patients with HA lasting over 10 years at the age of 75-85. The test confirming the history of stroke was obtained from medical records. RESULTS: In the study, no significant differences were found in the incidence of stroke between younger patients and those older than 85 years. In the group of patients treated for more than 10 years due to hypertension, the percentage of patients with diagnosed stroke was slightly higher than in patients treated for shorter periods, however these were not statistically significant differences p <0.43. CONCLUSIONS: In the study population, the incidence of stroke was not significantly influenced by the age or duration of hypertension.

[Evaluation of selected results of laboratory blood tests in the course of hypertension in elderly patients]. / Ocena wybranych wyników badan laboratoryjnych krwi w przebiegu nadcisnienia tetniczego u chorych w podeszlym wieku.

Hypertension is one of the most common chronic diseases. The incidence is estimated at about 30% of the general population, with a clear tendency of increasing the frequency with age. AIM: The aim of the study was to assess selected results of laboratory blood tests in the course of hypertension in elderly patients. MATERIALS AND METHODS: The study involved 63 women and 17 men, aged from 75 to 93 years, who were diagnosed with arterial hypertension in accordance with the guidelines of the Polish Society of Hypertension. Patients were divided into two pairs of groups - in terms of the duration of hypertension and the age of the subjects. Blood samples were taken in patients to determine blood counts, glucose, creatinine, total cholesterol, LDL, HDL and triglycerides. In the morphological examination of the blood, the number of leukocytes, erythrocytes and platelets in 1 µl of blood was assessed, as well as the concentration of CRP, ALAT and ASPAT were assessed. RESULTS: In the study, no significant differences were found between the results of selected biochemical tests and peripheral blood morphology between the analyzed subgroups of patients with respect to age and also depending on the duration of hypertension. CONCLUSIONS: Both the older age of patients and the duration of hypertension do not significantly affect the results of selected blood laboratory tests in the study population.

[Assessment of the intima and media of carotid arteries in the course of hypertension in the elderly]. / Ocena kompleksu blony wewnetrznej i srodkowej tetnic szyjnych w przebiegu nadcisnienia tetniczego u osób w podeszlym wieku.

According to the position of the European Society of Hypertension in 2009, the thickening of the inner and middle membrane complex of the carotid arteries (I-M CCA), or the finding of atherosclerotic plaques is associated with high cardiovascular risk. The increase in I-M CCA thickness, assessed within the carotid artery, is considered the initial stage of atherosclerosis. According to the concept of parallel development of atherosclerosis in many arterial areas I-M CCA is a recognized marker of the process involving other arteries, such as coronary arteries, kidney or lower limbs. AIM: The aim of the study was evaluation of the intima and media of carotid arteries - I-M in the course of hypertension in the elderly. MATERIALS AND METHODS: The study involved 63 women and 17 men, aged from 75 to 93 years, who were diagnosed with arterial hypertension in accordance with the guidelines of the Polish Society of Hypertension. Patients were divided into two groups. The first pair consisted of a group of 1 hypertensive patients (HA) lasting up to 10 years of age over 85 years and a group of 2 patients with HA lasting up to 10 years at the age of 75-85 years. The second pair is group I - patients with HA over 10 years of age over 85 years and group II - patients with HA lasting over 10 years at the age of 75-85. Carotid artery examination was performed using the Aloka SSD-1100 ultrasound machine. The measurements were made within the left and right carotid wall of the common carotid artery in the anterior and lateral-posterior projection. The maximum thickness of the inner and middle membranes was measured in three places within two segments of the common carotid artery. RESULTS: It was observed that in the group of patients treated longer due to hypertension, the thickness of the intima-media complex is significantly higher than in patients with shorter duration. Moreover, in the examined group of patients in the analysis of individual correlations, life expectancy was influenced, among others, by significantly on the thickness of I-M CCA. CONCLUSIONS: Both the older age of patients and the longer duration of hypertension caused thickening of the intima-media complex. The duration of hypertension greater than 10 years had a greater impact on the thickness of this complex than the age of the patients.

[Echocardiographic evaluation in the course of hypertension in the elderly]. / Ocena echokardiograficzna w przebiegu nadcisnienia tetniczego u osób w podeszlym wieku.

Factor contributing to the high prevalence of hypertension in the elderly is currently observed high survival rate of people diagnosed and treated hypertension, as well as the aging process itself. Detection of systemic complications was considered to be an important element of the diagnosis of hypertension as well as an important parameter of prognosis. Nowadays, echocardiography is the main tool used to assess heart cavities and to diagnose ventricular hypertrophy. AIM: The aim of the study was echocardiographic evaluation of the heart in the course of hypertension in the elderly. MATERIALS AND METHODS: 80 patients (63 women and 17 men) aged 75 to 93 years (mean age 81±5.3 years) with diagnosed hypertension were enrolled. Patients were divided into two groups because of the duration of hypertension and age. Hypertension was diagnosed based on clinical measurements. All patients underwent echocardiography. RESULTS: The echocardiographic study showed a significant effect of duration of hypertension on the dimensions of both the left ventricular heart chambers and the thickness of the ventricular septum and the posterior wall. CONCLUSIONS: Long-term hypertension results in left atrium and right ventricular hypertrophy, diminished left ventricular systolic and diastolic dimensions, and increases ventricular septal thickness in diastole and posterior wall thickness, without affecting the diastolic dimension of the right ventricle.

In-hospital outcomes and mortality in octogenarians after percutaneous coronary intervention.

BACKGROUND: There is systematic growth in the number of number of elderly patients treated with percutaneous coronary intervention (PCI); however, little is known about PCI results in the very elderly (long-lived) patients aged 85 years and above. AIM: To assess the demographic, clinical, and angiographic findings in patients aged > 85 years (GER), undergoing PCI, compared with younger patients treated in the year 2012. METHODS: This was a single centre retrospective study based on a consecutive group of 920 patients with coronary disease (stable and acute coronary syndrome [ACS]). Patients were divided into two groups: GER aged 85 years and over (n = 82) and controls (CG) below 85 years (n = 838). RESULTS: The mean age in the GER group was 88.6 vs. 66.7 years in the CG. There were more females in the GER group (57% vs. 29%) than in the CG (p < 0.001). The indication for PCI was mainly ACS in GER (65%) vs. CG (50%) including ST segment elevation myocardial infarction (STEMI) 30% vs. 29% (p = NS), ACS non-STEMI 35% vs. 20% (p = 0.01). GER patients had more comorbidities and more advanced multivessel coronary artery disease. The ratio of procedural success was lower in GER compared to CG. The incidence of in-hospital death was higher in GER (4.8%) compared to CG (0.83%); the most common complication in GER group was contrast-induced nephropathy (18.2% vs. 6.2%). Major adverse cardiovascular events were significantly more frequent in GER patients with ACS compared to CG patients with the same diagnosis. CONCLUSIONS: Patients > 85 years old, especially with ACS undergoing PCI, are at greater risk of in-hospital complications, especially contrast-induced nephropathy and procedural complications, compared to younger patients.

[Vascular dysfunction in young patients with impaired glucose tolerance: insights from pulse wave velocity and endothelial function measurements]. / Dysfunkcja naczyn tetniczych u mlodych pacjentów z uposledzona tolerancja glukozy.

UNLABELLED: Endothelial dysfunction is regarded as an early marker of atherosclerosis and decreased arterial disstensibility has similar significance. The aim of this study was to evaluate endothelial function and arterial distensibility in patients with impaired glucose tolerance which may constitute markers of atherosclerosis. METHODS: Study group consisted of patients without chest pain, ischemic ECG changes, arterial hypertension or any risk factors for IHD, who were divided into two groups: Impaired glucose tolerance group (ITG)--48 patients with fasting glucose levels of 5.7 +/- 0.2 mmol/l and glucose levels of 9.2 +/- 0.6 mmol/l 2 hours after starting a 75 g oral glucose load and group 2-43 healthy age and sex matched controls with fasting glucose levels of 4.9 +/- 0.5 mmol/l and normal glucose tolerance. Endothelium dependent (EDV) and independent vasodilation (EIV) was assessed with 8 MHz high resolution ultrasound (Acuson Sequoia) according to Celermajer's method. PWV was measured with Complior Colson automatic device with measurement points above femoral and carotid artery. RESULTS: Flow associated with vasodilation was significantly impaired in ITG group (6.1 +/- 3.1% vs 13.4 +/- 3.9%-controls, p < 0.001). EIV was not significantly different between both groups. PWV was significantly higher in patients with impaired glucose tolerance than in controls (9.9 +/- 0.5 m/s vs 7.8 +/- 0.9 m/s) p < 0.001. CONCLUSIONS: Increased values of PWV indicate an increased arterial stiffness in patients with ITG, coexisting with endothelial dysfunction. These results reveal vascular dysfunction and potentially increased risk for development of atherosclerosis in ITG patients.