Thực trạng tăng huyết áp và nguy cơ ngã ở người cao tuổi điều trị ngoại trú tại Bệnh viện Lão khoa Trung ương
Nội dung chính của bài viết
Tóm tắt
Nghiên cứu đánh giá thực trạng tăng huyết áp (THA) và mối liên quan với nguy cơ ngã ở bệnh nhân ngoại trú cao tuổi. Nghiên cứu mô tả cắt ngang được thực hiện trên 529 bệnh nhân từ 60 tuổi trở lên, không suy giảm nhận thức đến khám tại Bệnh viện Lão Khoa Trung ương từ tháng 01 - 12/2018. Kết quả đã chỉ ra tỷ lệ THA là 55,4% (94,5% THA được điều trị và 48,5% kiểm soát được huyết áp mục tiêu), cứ 5 bệnh nhân ≥ 60 tuổi có 1 người nguy cơ ngã cao (21%); các tỷ lệ này tăng dần khi tuổi tăng lên. Tỷ lệ bệnh nhân có nguy cơ ngã cao ở nhóm THA lớn hơn so với nhóm không THA, p < 0,001. Kết quả nghiên cứu đã xác định được một số yếu tố liên quan đến nguy cơ ngã cao, bao gồm: tuổi ≥ 80 (OR 5,44; 95%CI: 2,28-12,96), bệnh nhân THA (OR 1,93; 95%CI: 1,13-3,28), tiền sử ngã trong 1 năm trước tham gia nghiên cứu (OR 3,77; 95%CI: 1,96 – 7,25), trong khi THA điều trị kiểm soát được HA mục tiêu là yếu tố bảo vệ (OR 0,42; 95%CI: 0,25-0,71). THA phổ biến ở người cao tuổi và có liên quan với tăng nguy cơ ngã. Điều trị THA và kiểm soát huyết áp mục tiêu là cần thiết để giảm nguy cơ ngã.
Chi tiết bài viết
Từ khóa
Tăng huyết áp, Nguy cơ ngã, Người cao tuổi
Tài liệu tham khảo
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2. Nguyen T-P-L, Wright EP, Nguyen T-T, et al. Cost-effectiveness analysis of screening for and managing identified hypertension for cardiovascular disease prevention in Vietnam. PloS one. 2016;11(5):e0155699.
3. Yusuf S, Joseph P, Rangarajan S, et al. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. The Lancet. 2020;395(10226):795-808.
4. Anandita M, Mehta A, Yang E, Parapid B. Older Adults and Hypertension: Beyond the 2017 Guideline for Prevention, Detection. Evaluation, and Management of High Blood Pressure in Adults. 2020;26.
5. Abegaz TM, Shehab A, Gebreyohannes EA, Bhagavathula AS, Elnour AA. Nonadherence to antihypertensive drugs: a systematic review and meta-analysis. Medicine. 2017;96(4).
6. Abate M, Di Iorio A, Pini B, et al. Effects of hypertension on balance assessed by computerized posturography in the elderly. Archives of gerontology and geriatrics. 2009;49(1):113-117.
7. Ozaldemir I, Iyigun G, Malkoc M. Comparison of processing speed, balance, mobility and fear of falling between hypertensive and normotensive individuals. Brazilian journal of physical therapy. 2019.
8. Panel on Prevention of Falls in Older Persons AGS, Society BG. Summary of the updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. Journal of the American Geriatrics Society. 2011;59(1):148-157.
9. Dionyssiotis Y. Analyzing the problem of falls among older people. International journal of general medicine. 2012;5:805-813.
10. EuroSafe A. Falls among older adults in the EU-28: key facts from the available statistics. In:2015.
11. Kulkarni S, Rao R, Goodman JDH, Connolly K, O'Shaughnessy KM. Nonadherence to antihypertensive medications amongst patients with uncontrolled hypertension: A retrospective study. Medicine. 2021;100(14).
12. Rosli R, Tan MP, Gray WK, Subramanian P, Chin A-V. Cognitive assessment tools in Asia: a systematic review. International psychogeriatrics. 2016;28(2):189.
13. Van NB, Hoang LV, Van TB, et al. Prevalence and risk factors of hypertension in the Vietnamese elderly. High Blood Pressure & Cardiovascular Prevention. 2019;26(3):239-246.
14. Barry E, Galvin R, Keogh C, Horgan F, Fahey T. Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis. BMC geriatrics. 2014;14(1):1-14.
15. Williams B, Mancia G, Spiering W, et al. ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur heart J. 2018;39(33):3021-3104.
16. Unger T, Borghi C, Charchar F, et al. 2020 International Society of Hypertension global hypertension practice guidelines. Hypertension. 2020;75(6):1334-1357.
17. Gangavati A, Hajjar I, Quach L, et al. Hypertension, orthostatic hypotension, and the risk of falls in a community‐dwelling elderly population: the maintenance of balance, independent living, intellect, and zest in the elderly of Boston study. Journal of the American Geriatrics Society. 2011;59(3):383-389.
18. Who EC. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet (London, England). 2004;363(9403):157.
19. Meiqari L, Essink D, Wright P, Scheele F. Prevalence of hypertension in Vietnam: a systematic review and meta-analysis. Asia Pacific Journal of Public Health. 2019;31(2):101-112.
20. Quoc Cuong T, Van Bao L, Anh Tuan N, et al. Associated factors of hypertension in women and men in vietnam: A cross-sectional study. International journal of environmental research and public health. 2019;16(23):4714.
21. Volpe M, Battistoni A, Rubattu S, Tocci G. Hypertension in the elderly: which are the blood pressure threshold values? European heart journal supplements: journal of the European Society of Cardiology. 2019;21(Suppl B):B105.
22. Islam CMZ, Meshbahur R, Tanjila A, et al. Hypertension prevalence and its trend in Bangladesh: evidence from a systematic review and meta-analysis. Clinical Hypertension. 2020;26(3):40-58.
23. Fryar CD, Ostchega Y, Hales CM, Zhang G, Kruszon-Moran D. Hypertension prevalence and control among adults: United States, 2015-2016. 2017.
24. Mishra VK. Epidemiology of obesity and hypertension in Uzbekistan. ORC Macro; 2005.
25. Son P, Quang N, Viet N, et al. Prevalence, awareness, treatment and control of hypertension in Vietnam—results from a national survey. Journal of human hypertension. 2012;26(4):268-280.
26. Iqbal A, Ahsan KZ, Jamil K, et al. Demographic, socioeconomic, and biological correlates of hypertension in an adult population: evidence from the Bangladesh demographic and health survey 2017–18. BMC Public Health. 2021;21(1):1-14.
27. Subramanian MS, Singh V, Chatterjee P, Dwivedi SN, Dey AB. Prevalence and predictors of falls in a health‐seeking older population: An outpatient‐based study. Aging Medicine. 2020.
28. Stenhagen M, Nordell E, Elmståhl S. Falls in elderly people: a multifactorial analysis of risk markers using data from the Swedish general population study ‘Good Ageing in Skåne’. Aging clinical and experimental research. 2013;25(1):59-67.
29. NICE CfCPa. Falls: Assessment and prevention of falls in older people. 2013.
30. Hausdorff JM, Herman T, Baltadjieva R, Gurevich T, Giladi N. Balance and gait in older adults with systemic hypertension. American Journal of Cardiology. 2003;91(5):643-645.
31. Bankoff ADP. Study on body balance in hypertensive patients. J Hypertens Open Access. 2012;1:2167-1095.1000101.
32. Kiel DP, Schmader K, Lin F. Falls in older persons: Risk factors and patient evaluation. UpToDate Waltham: UpToDate Inc. 2018.
33. Sturnieks DL, St George R, Lord SR. Balance disorders in the elderly. Neurophysiologie clinique = Clinical neurophysiology. 2008;38(6):467-478.
34. Juraschek SP, Taylor AA, Wright Jr JT, et al. Orthostatic hypotension, cardiovascular outcomes, and adverse events: results from SPRINT. Hypertension. 2020;75(3):660-667.
35. Ellmers TJ, Kal EC, Richardson JK, Young WR. Short-latency inhibition mitigates the relationship between conscious movement processing and overly cautious gait. Age and ageing. 2021;50(3):830-837.
36. Luiting S, Jansen S, Seppälä L, Daams J, van der Velde N. Effectiveness of cardiovascular evaluations and interventions on fall risk: a scoping review. The journal of nutrition, health & aging. 2019;23(4):330-337.
37. Bộ Y Tế. Dự thảo đề cương đề án chăm sóc sức khỏe người cao tuổi giai đoạn 2010-2020. Báo cáo của Bộ Y Tế Việt Nam. 2017.
38. Tran MT, Dang LT, Vu NC. Vietnamese Older Persons. Nguyen Cong Vu Mai Thi Tran Linh Thuy Dang Choy-Lye Chei. 2020:23.