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Objective:To study the effect of lifestyle intervention and Irbesartan intervention on vascular endothelial function in elderly people with prehypertension.Methods:Seventy elderly people with prehypertension were randomly divided into the lifestyle intervention group and the Irbesartan intervention group.After one year of intervention, the level of cyclic endothelial microparticles(EMPs)and brachial-ankle pulse wave conduction velocity(baPWV)before and after the intervention were compared between the two groups.Results:There were significant differences in levels of circulating EMPs[(1 946±234)/μl vs.(1 745±416)/μl, t=2.530, P=0.011]and baPWV[(1 653±172)cm/s vs.(1 511±230)cm/s, t=2.448, P=0.017]before and after one year of lifestyle intervention.There were also significant differences in levels of circulating EMPs[(19 507±146)/μl vs.(1 446±286)/μl, t=3.340, P=0.002]and baPWV[(1 639±165)cm/s vs.(1 361±211)cm/s, t=3.156, P=0.005]before and after one year of Irbesartan intervention and between the lifestyle intervention group and the Irbesartan intervention group after one year( t=2.238 and 2.475, P<0.05). Conclusions:Lifestyle intervention and Irbesartan intervention have protective effects on vascular endothelial function and delay the initiation and progression of atherosclerosis in elderly people with prehypertension, and irbesartan intervention is more effective than lifestyle intervention.
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<p><b>OBJECTIVE</b>To analyze the correlation between mitral regurgitation grading and left ventricular ejection fraction in elderly patients (>60 years of age) in a 2-year follow-up.</p><p><b>METHODS</b>A total of 455 patients with the diagnosis of at least mild mitral regurgitation by echocardiography were divided into ischemic mitral regurgitation (IMR) group and non-ischemic regurgitation (NIMR) group. The patients were followed up with echocardiography every 6 months and the data were analyzed at the end of 24 months.</p><p><b>RESULTS</b>Mitral regurgitation grade was inversely correlated with left ventricular ejection fraction (LVEF). Patients with moderate and severe IMR had a lower LVEF than those with NIMR (P<0.05). After adjustment for age, sex, body mass index, high blood pressure, diabetes, atrial fibrillation and cardiomyopathy, the mean LVEF at 2 years was lowered by 2.7% (1.4%-4.1%), 2.7% (1.3%-4.0%), and 5.2% (3.5%-6.9%) in mild, moderate and severe IMR patients, respectively (P<0.04), and by 3.2% (1.6%-4.8%), and 3.0% (1.4%-4.5%), and 1.7%(-0.5%-3.9%) in mild, moderate and severe NIMR patients (P=0.30).</p><p><b>CONCLUSION</b>The mean LVEF in IMR patients is significantly lowered compared to that in NIMR patients. The grade of mitral regurgitation is inversely correlated with the regurgitation area in IMR patients. Stratified management might help improve LVEF in severe IMR patients.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Follow-Up Studies , Mitral Valve Insufficiency , Stroke Volume , Ventricular Dysfunction, LeftABSTRACT
Objective To evaluate the prevalence of obstructive sleep apnea syndrome (OSAS) and its characteristics in elderly patients with cardiovascular diseases, and provide reference for the clinical decisions. Methods All patients who were hospitalized in department of cardiovascular medicine from January to June in 2007 were invited to participate in the current study. A total of 317 hospitalized elderly patients were recruited into this study. All participants were assessed by portable bedside nocturnal polysomnograph and Epworth sleepiness scale (ESS). Results Among 317 patients, 281 cases (88.6%) met the criterion of obstructive sleep apnea (OSA) [apnea and hypopnea index (AHI)≥5] and 47 cases (14.8%) met the criteria of obstructive sleep apnea syndrome (OSAS) (AHI≥5 and ESS≥9). When the severity of OSA (as indicated by AHI) was considered as a dependent variable, multiple regression analysis indicated that it was significantly associated with minimal SaO2 and the oxygen desaturation index, while age, habitual snoring, ESS, BMI, mean SaO2 and the duration of SaO2≤ 90% did not show significant effects on the severity of OSA. Conclusions High prevalence of obstructive sleep apnea syndrome (with daytime sleepiness) is found in elderly hospitalized patients and the rate of obstructive sleep apnea is much higher in patients without daytime sleepiness symptoms. Minimal SaO2 and the oxygen desaturation index are the important predicting factors for the severity of OSA, while age, BMI, habitual snoring, sleepiness are not correlated with the severity of OSA after adjusting minimal SaO2 and oxygen desaturation index.