Frailty in Chinese older adults with hypertension: Prevalence,associated factors,and prediction for long‐term mortality

Hypertension and frailty are associated and often coexist in older adults. Few studies have examined the association between hypertension and frailty in Chinese population. We explored the prevalence of and the factors associated with frailty as well as whether frailty could identify patients at risk of adverse outcomes among older adults with hypertension. Data were from the Beijing Longitudinal Study of Aging. A total of 1111 hypertensive participants aged ≥60 years old who completed the comprehensive geriatrics assessment were included. All participants were followed up for 8 years. The total number of deaths was 604. Frailty was assessed by the 68‐item frailty index. Stepwise forward logistic regression was used to explore the association between the associated factors and frailty in hypertensive participants. The prediction for mortality was assessed using the adjusted Cox proportional hazards model. Two hundred and eighteen older adults were determined as frail (prevalence rate: 19.6%). Frail older adults with hypertension had worse physical performance, worse psychological, and social function, as well as worse lifestyle habits, compared to nonfrail older adults with hypertension. Chair stand test failure, balance test failure, fracture, disability, depression, and physical frailty measured with modified frailty phenotype were independently associated with frailty. Frailty was associated with a higher 8‐year mortality, hazard ratio (HR) = 3.40, adjusted for age and sex, HR = 2.61. Frailty is associated with poorer physical function and higher mortality in community‐dwelling hypertensive older adults in China. These findings emphasize the importance and need for frailty intervention and prevention in older adults with hypertension.     

Hypertension prevalence and control among community‐dwelling lebanese older adults

There is a high prevalence of hypertension among Lebanese adults, but no evidence is available on its prevalence and control exclusively among older adults (65 + years). This study provides the first evidence on a representative sample of 502 community elderly and presents the basis for future research and policy implications. Results show an overall prevalence of 52% with a significantly higher female‐to‐male ratio. Factors independently associated with hypertension were older age, body mass index, and dementia. More than a third of those with a positive history of hypertension had uncontrolled blood levels. Uncontrolled hypertension was higher among women. Increasing awareness about medication adherence and controlling multi‐morbidities constitute promising measures to lowering the burden of hypertension among Lebanese older adults, especially women.     

Prevalence and determinants of hypertension and associated cardiovascular risk factors: data from a population-based,cross-sectional survey in Saint Louis,Senegal

Background

The incidence of cardiovascular disease is growing worldwide and this is of major public health concern. In sub-Saharan Africa, there is a lack of epidemiological data on the prevalence and distribution of risk factors of cardiovascular disease. This study aimed at assessing the prevalence of hypertension and other cardiovascular risk factors among an urban Senegalese population.

Methods

Using an adaptation of the WHO STEPwise approach to chronic disease risk-factor surveillance, we conducted a population-based, cross-sectional survey from 3 to 30 May 2010 on 1 424 participants aged over 15 years. Socio-demographic and behavioural risk factors were collected in step 1. Physical anthropometric measurements and blood pressure were documented in step 2. Blood tests (cholesterol, fasting blood glucose, and creatinine levels) were carried out in step 3.

Results

The prevalence of hypertension was 46% (95% CI: 43.4–48%), with a higher prevalence in females (47.9%) than males (41.7%) (p = 0.015), and 50% of these hypertensive were previously undiagnosed. Mean age was 53.6 years (SD: 15.8). In known cases of hypertension, the average length of its evolution was 6 years 9 months (range 1 month to 60 years). Hypertension was significantly associated with age (p = 0.001), socio-professional category (p = 0.003), dyslipidaemia (p < 0.001), obesity (p < 0.001), physical inactivity (p < 0.001), diabetes (p < 0.001) and stroke (p < 0.001).

Conclusion

We found a high prevalence of hypertension and other cardiovascular risk factors in this population. There is need of a specific programme for the management and prevention of cardiovascular disease in this population.     

Hypertension and associated factors in older adults in South Africa

Background

Older adults are disproportionately affected by hypertension, which is an established risk factor for cardiovascular disease. Little attention has been focused on hypertension and associated factors among older adults in Africa. Therefore, this study aimed to investigate the prevalence and associated factors of hypertension in a national sample of older South Africans who participated in the Study of Global Ageing and Adults’ Health (SAGE) in 2008.

Methods

In 2008 we conducted a national, population-based, cross-sectional study of a sample of 3 840 subjects aged 50 years or older in South Africa. The questionnaire included socio-demographic characteristics, health variables, and anthropometric and blood pressure measurements.

Results

The prevalence of hypertension in the sample population was 77.3% (male 74.4%, female 79.6%). The rates of awareness, treatment and control among the hypertensive participants were 38.1, 32.7 and 17.1%, respectively. The results of multivariate logistic regression analysis revealed that the prevalence of hypertension was associated with being in the Coloured population group, having had a stroke, being overweight or obese and having had five or more out-patients care visits in the past 12 months. Hypertension was inversely associated with current alcohol use.

Conclusion

This study revealed high rates of hypertension among older adults (50 years and more) in South Africa, which puts them at risk for cardiovascular disease. The percentages of hypertensive subjects who were aware, treated and controlled were very low. These data underscore the urgent need to strengthen the public health education and blood pressure-monitoring systems to better manage hypertension among older adults in South Africa.     

Antihypertensive medication use and blood pressure control among treated older adults

The association of different antihypertensive regimens with blood pressure (BP) control is not well‐described among community‐dwelling older adults with low comorbidity. We examined antihypertensive use and BP control in 10 062 treated hypertensives from Australia and the United States (US) using baseline data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial. Renin‐angiotensin system (RAS) drugs were the most prevalently used antihypertensive in both countries (Australia: 81.7% of all regimens; US: 62.9% of all regimens; P < .001). Diuretics were the next most commonly used antihypertensive in both countries, but were more often included in regimens of US participants (48.9%, vs 33.3% of regimens in Australia; P < .001). Among all antihypertensive classes and possible combinations, monotherapy with a RAS drug was the most common regimen in both countries, but with higher prevalence in Australian than US participants (35.9% vs 20.9%; P < .001). For both monotherapy and combination users, BP control rates across age, ethnicity, and sex were consistently lower in Australian than US participants. After adjustment for age, sex, ethnicity, and BMI, significantly lower BP control rates remained in Australian compared to US participants for the most commonly used classes and regimens (RAS blocker monotherapy: BP control = 45.5% vs 54.2%; P = .002; diuretic monotherapy: BP control = 45.2% vs 64.5%; P = .001; and RAS blocker/diuretic combo: BP control = 50.2% vs 65.6%; P = .001). Our findings highlight variation in antihypertensive use in older adults treated for hypertension, with implications for BP control. Differences in BP control that were observed may be influenced, in part, by reasons other than choice of specific regimens.     

Prevalence of isolated diastolic hypertension and associated risk factors among adults in Kanpur, India

BackgroundIsolated diastolic hypertension (IDH) is a largely unrecognized subtype of hypertension, more commonly seen in the younger age group.Aims(1) To determine the prevalence of IDH in the adult population of Kanpur district. (2) To study the associated risk factors of IDH.MethodsA community-based cross-sectional study was conducted in 801 subjects, aged 20 years and above, using multistage stratified random sampling technique.ResultsThe prevalence of IDH was 4.5%, which was 6.2% in men and 3.1% in women. A significant proportion of IDH was seen in the 40–49 years age group. Multivariate logistic regression analysis of the associated risk factors showed that gender, physical activity and BMI were significantly associated with IDH.ConclusionIsolated diastolic hypertension is an emerging problem in developing countries. IDH is more common among men, sedentary individuals and those with a higher BMI.     

Participation of metropolitan, urban and rural community-dwelling older adults

Environmental factors are important in maintaining a high level of participation. This cross-sectional study aimed at comparing the level of participation of older adults living in rural, urban and metropolitan environments and exploring sociodemographic factors associated with participation according to each type of environment. A total of 350 community-dwelling participants showing a normal aging process were randomly recruited. Participation in daily activities and social roles was measured with the Assessment of Life Habits. Sociodemographic and environmental data were gathered using a questionnaire. Participants from the rural region reported less schooling, a lower income, no access to public transportation and less access to stores than others. Participants from the metropolitan region differed in terms of less use of a car, less satisfaction with their social support and feeling less secure in their neighborhood. However, no significant difference was found between the metropolitan, urban and rural groups for participation in daily activities and social roles. Furthermore, the variables most associated with participation were similar for all three regions. This suggests that although the environment of older adults living in metropolitan, urban and rural region differs, their level of engagement in daily activities and social roles is similar.     

Transient versus persistent fear of falling in community-dwelling older adults: incidence and risk factors

OBJECTIVES: To investigate the incidence of fear of falling (FOF) and the risk factors associated with transient versus persistent FOF in community‐dwelling older adults. DESIGN: Prospective cohort study. SETTING: Bronx County, New York. PARTICIPANTS: Three hundred eighty participants without FOF at baseline in the Einstein Aging Study aged 70 and older. MEASUREMENTS: FOF was assessed at baseline and during follow‐up interviews at 2‐ to 3‐month intervals for a minimum 2 years. Incident FOF was classified as transient or persistent FOF. Transient FOF was defined as new‐onset FOF reported at only one interview, and persistent FOF was FOF reported at two or more interviews over a 2‐year period. RESULTS: Twenty‐four‐month cumulative incidence of incident FOF was 45.4%, with 60.0% of FOF being persistent. Predictors of incident FOF included female sex (adjusted hazard ratio (aHR)=1.55, 95% confidence interval (CI)=1.08–2.23), depressive symptoms (aHR=1.16, 95% CI=1.07–1.26), falls (aHR=1.50, 95% CI=1.01–2.21), and clinical gait abnormality (aHR=2.07, 95% CI=1.42–3.01). The proportion of participants with incident FOF increased linearly with increasing number of risk factors. Predictors for transient and persistent FOF were depressive symptoms and clinical gait abnormality. Female sex and previous falls were predictors of persistent but not transient FOF. CONCLUSION: FOF status in older adults may change over time, with shared and distinct risk factors for persistent and transient FOF. Understanding the dynamic nature of FOF and these risk factors will help identify high‐risk groups and design future intervention studies.     

Prevalence, awareness, treatment, and control of hypertension among adults in Beijing, China

Hypertension is an important modifiable risk factor for cardiovascular diseases. This study aimed to determine the up-to-date prevalence, awareness, treatment, and control of hypertension, and their related influencing factors in adults in Beijing, China. A cross-sectional study was conducted in 2008. A total of 5760 adults aged 18-79 years were selected from the general population. Data from a standardized questionnaire, physical examination, and blood sample were obtained. The prevalence of hypertension was 35.5% (41.8% in men, 30.9% in women) and increased with age in both sexes. The prevalence was similarly high in urban (35.6%) and in rural (34.9%) areas. Body mass index (BMI) and waist circumference were independently associated with hypertension. Participants with diabetes and/or dyslipidemia had higher prevalence of hypertension than their counterparts. Among hypertensive patients, 42.5% were aware of the diagnosis, 35.9% received treatment, and 11.8% had hypertension control. Awareness and treatment of hypertension were low in men, young people, and rural residents. Control of hypertension was lower in older people and those with lower educational attainment. High waist circumference (central obesity) resulted in low control of hypertension (odds ratio = 0.45). Our findings underscore the urgent need to develop a comprehensive health strategy for the prevention, detection, and control of hypertension to avert the cardiovascular disease epidemic in Beijing.     

Prevalence and correlates of functional disability in Chinese older adults

Aim:   This article examines the prevalence of functional disability as well as sociodemographic correlations among Chinese older adults based on the most recent China National Sample Survey on Disability in 2006.
Methods:   Functional disability was defined as lost motor function or limited movements and activities according to the International Classification of Function, Disability and Health, and physicians made the diagnosis of disability. Utilizing stratified, multiphase and cluster probability sampling design, a nationally representative sample of the non-institutionalized elderly Chinese population was studied. Factors associated with functional disability were determined using a logistic regression model.
Results:   The prevalence of functional disability was 8.1%. Major causes were vascular disease, osteoarthritis and accidents. In the non-institutionalized elders, increased age, rural residence, less education, lower income, unemployment, being unmarried, living in simple housing, and living with others or non-homeowners emerged as factors associated with functional disability in men and women.
Conclusion:   To face the challenge of the rising prevalence of functional disability, prevention strategies should focus on reducing the incidences of chronic disease and improving socioeconomic status of older adults.     

Prevalence and characteristics of apparent treatment-resistant hypertension in older people in China: a cross-sectional study

ABSTRACT

The prevalence and associated risk factors of apparent treatment-resistant hypertension (aTRH) in older people in China is unknown. The aim of this study is to investigate the prevalence of aTRH in older people and describe the characteristics of older patients with aTRH. Using two-stage random clustering sampling, 3774 patients with hypertension aged ≥60–75 years were recruited between July 2012 and December 2015. The patients were divided into two groups: aTRH and non-aTRH groups according to their blood pressure (BP) levels, and whether or not they reached goal BP value. A multivariable logistical model was used to evaluate the risk factors of aTRH. The rate of antihypertensive treatment was 75.1%, BP control rate was 40.7%, and the prevalence of aTRH was 5.97% (169) according to the cross-sectional data among all the patients. The prevalence of aTRH patients taking 4 different classes of antihypertensive drugs or more was found to be 3.29% (93) in this study. Compared with non-aTRH patients, those with aTRH had a worse cardiovascular risk profile, including obesity (29.61% vs 20.53%, P = 0.005), hyperlipidemia (54.44% vs 46.66%, P = 0.050), type 2 diabetes mellitus (2-DM) (34.31% vs 25.64%, P = 0.013), and stroke (26.03% vs 19.26%, P = 0.032). After multivariable adjustment, logistic regression analyses showed that the risk factors of aTRH were male sex (OR 1.638; 95%CI 1.196–2.245, P = 0.002) and 2-DM (OR 1. 371; 95%CI 0.995–1.888, P = 0.049). Regular physical exercise (OR 0.696; 95%CI 0.505–0.960, P = 0.049) was a protective factor of aTRH. The prevalence of aTRH was 5.97% in older people in this cross-sectional study in China.     

Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004

Detection of hypertension and blood pressure control are critically important for reducing the risk of heart attacks and strokes. We analyzed the trends in the prevalence, awareness, treatment, and control of hypertension in the United States in the period 1999-2004. We used the National Health and Nutrition Examination Survey 1999-2004 database. Blood pressure information on 14 653 individuals (4749 in 1999-2000, 5032 in 2001-2002, and 4872 in 2003-2004) aged >or=18 years was used. Hypertension was defined as blood pressure >or=140/90 mm Hg or taking antihypertensive medications. The prevalence of hypertension in 2003-2004 was 7.3+/-0.9%, 32.6+/-2.0%, and 66.3+/-1.8% in the 18 to 39, 40 to 59, and >or=60 age groups, respectively. The overall prevalence was 29.3%. When compared with 1999-2000, there were nonsignificant increases in the overall prevalence, awareness, and treatment rates of hypertension. The blood pressure control rate was 29.2+/-2.3% in 1999-2000 and 36.8+/-2.3% in 2003-2004. The age-adjusted increase in control rate was 8.1% (95% CI: 2.4 to 13.8%; P=0.006). The control rates increased significantly in both sexes, non-Hispanic blacks, and Mexican Americans. Among the >or=60 age group, the awareness, treatment, and control rates of hypertension had all increased significantly (P相似文献   

Age identity, self-rated health, and life satisfaction among older adults in Dakar, Senegal

The objectives of this quantitative study were to (1) ascertain to what extent older adults aged 50 and above feel and desire to be younger than their age, and classify themselves as young versus old; (2) compare these patterns with those found among other cross-cultural populations; and (3) assess the extent to which self-rated health and life satisfaction predict age identities. This study was carried out on a sample of 500 dwellers of the Senegalese capital aged 50 and older. This sample was constructed using the quota method to strive for representativeness. Most of the respondents wanted to be younger than their chronological age (51.8 %), but only 27.8 % felt younger than they were. Moreover, 80 % of the sample claimed to be old. Self-rated health predicted felt age and the feeling of being old. Furthermore, the less-satisfied Dakar residents were with their life, the younger they wanted to be. We first discuss our results in a comparative perspective focused on how orientations toward individualism and collectivism could be related to age identity, and on demographic characteristics of the Senegalese population—where life expectancy is 59.3 years old. We then analyze the relevance of age identity dimensions as indicators of successful aging in Dakar.     

The prevalence and risk factors for sarcopenia in older adults and long-living older adults

PurposeSarcopenia is a muscular syndrome that is related to several adverse risks. The present study aimed to evaluate the prevalence of risk of sarcopenia and associated factors in older adults and long-living older adults.MethodsA crosssectional epidemiological study of older adults patients at a geriatric outpatient clinic. The older adults were evaluated for sarcopenia risk using the SARC-F questionnaire supplemented with the measurement of the calf circumference. In addition, nutritional status was characterized using the Mini Nutritional Assessment, and the relationship of sarcopenia with associated factors (comorbidities, polypharmacy, smoking).ResultsA total of 100 eligible older adults with a mean age of 77.2 ± 1.8 years in the older adults and 86.3 ± 4.2 years in the long-living older adults (p < 0.001) were evaluated. The long-living older adults (OR = 6.1; 95 % CI: 1.44–16.09; p = 0.01) and older adults at risk of malnutrition (OR = 13.6; 95 % CI: 1.55–11.38; p < 0.05) had a higher risk of sarcopenia, whereas BMI ≥ 27 kg/m 2 (OR = 0; 95 % CI: 0–0.06; p < 0.001) was a protective factor. The risk of sarcopenia was six times higher in the over-80 s (95 % CI = 1.44, 16.09), while the older adults with malnutrition or at nutritional risk ran a 13 times higher risk of sarcopenia (95 % CI = 1.55, 11.38).ConclusionThe prevalence of risk of sarcopenia was higher in the long-living older adults and the older adults at nutritional risk, making its early evaluation in clinical practice important.     

Prevalence,awareness, treatment,and control of hypertension among Chinese working population: results of a workplace-based study

We investigated the prevalence, awareness, treatment, and control of hypertension and the related risk factors among Chinese working population. From 2012 to 2013, a total of 37,856 employees aged 18–60 years from 61 workplaces were sampled. Standard questionnaire surveys and physical examinations were undertaken. Multilevel logistic regression models were performed to identify the risk factors. Overall, the age-standardized prevalence of hypertension was 23.3% (95% confidence interval [CI]: 22.9%–23.7%). Among the hypertensives, 47.8% (95% CI: 46.8%–48.8%) were aware of their condition, 20.6% (95% CI: 19.8%–21.4%) were in treatment, but only 8.5% (95% CI: 7.9%–9.1%) had controlled hypertension. White-collar employees had a lower odds of hypertension compared with the blue-collar (odds ratio: 0.77, 95% CI: 0.71–0.84), whereas the state-owned enterprise employees had a higher odds compared with their private enterprise counterparts (odds ratio: 1.69, 95% CI: 1.07–2.65). Lower awareness and treatment were associated with being younger, higher education, and those from workplace without affiliated hospital. Higher occupation status individuals were more likely to be treated but no sign of better control. There is substantial room for improvement in hypertension diagnosis and treatment among the employees. Effective intervention programs are urgently needed at the workplaces.     

Socio-demographics,spirituality, and quality of life among community-dwelling and institutionalized older adults: A structural equation model

PurposeThe increasing life expectancy of the population prompts an array of health conditions that impair an older adults’ quality of life (QoL). Although demographics and spirituality have been associated with QoL, limited literature elucidated the exact mechanisms of their interactions, especially in a culturally-diverse country like Philippines. Hence, this study determined the relationship among socio-demographics, spirituality, and QoL of Filipino older adults in a community and institutional setting.Materials and methodsA predictive-correlational study among 200 randomly-selected community-dwelling and institutionalized older adults was conducted, with a 99% power and a medium effect size. Data were collected using a three-part questionnaire from September to November 2015. The questionnaire was composed of the robotfoto, Spirituality Assessment Scale, and modified Older People’s Quality of Life which assessed socio-demographics, spirituality, and QoL.ResultsAnalysis showed that institutionalization in a nursing home positively and negatively affected spirituality and QoL, generating an acceptable model (χ²/df = 2.12, RMSEA = 0.08, and CFI = 0.95). The negative direct effect of institutionalization on social relationship, leisure, & social activities QoL (β=–0.42, p < 0.01) also initiates a cascade of indirect negative effects on both spirituality and QoL dimensions.ConclusionsThe development of a structural model illustrating the interrelationship of socio-demographics, spirituality, and QoL helps healthcare professionals in predicting facets of spirituality and QoL that can be compromised by living in a nursing home. This understanding provides impetus in evaluating and refining geriatric healthcare programs, policies, and protocols to render individualized, holistic care in a socially-cohesive environment among older adults.