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Mar 21, 2019 in Articles
Hypertension and Different Risk Factors of Blood Pressure
Masked Hypertension in the Elderly: Cross-Sectional Analysis of a Population-Based Sample
Type of study. The article “Masked Hypertension in the Elderly: Cross-Sectional Analysis of a Population-Based Sample” presents a quantitative research assessing the frequency of masked hypertension in the elderly.
Location/Setting. The research was held in three French cities and consisted of defining the systolic and diastolic hypertension of the participants in two settings: in the office and at home. Consequently, the frequency of MHT was assessed in various populations and settings.
Concepts/Variables. The general concept of the article defines that the risk factors associated with MHT are the personal characteristic of individuals and are closely connected with elevated home BP. The elevated blood pressure at home showed the doubling of the risk of cardiovascular events. The participants measured their BP 12 times in different settings. Therefore, the influence of the home or office setting on a person is an independent variable. The dependent variable is the risk of vascular events, which grows or lowers according to the BP.
Theory. The framework of the research offers the idea that the risk factors for the MHT patients are associated with participants’ age, gender, physical activity, BP lowering medication consumption, and diabetes. As a result, the different activities connected with different settings can cause the change in systolic and diastolic BP of people with hypertension. However, the elevated blood pressure at home doubles the risk of cardiovascular events.
Research Design. The observational approach to the study was based on the data provided by 1814 participants, who followed the protocol provided for the experiment and made the home BP measurements for the research. The cohort study was held in three cities and according to the approved protocol on the basis of the routine data.
Sample. The community-based sample chosen for the study comprised 1814 participants, who were grouped according to different characteristics and tested under the same conditions. The main aim of the study was to evaluate the risk of dementia attributable to vascular factors.
Sample size. The values of hypertension for home were defined as 140 mm Hg for systolic BP and 90 mm Hg for diastolic BP. The values of hypertension for office were defined as 135 mm Hg for systolic BP and 85 mm Hg for diastolic BP.
Sampling Methods. The home and office BP measurements of the participants aged 75 years or older were all taken with the same device – OmronM6, Omron Healthcare, Kyoto, Japan. Participants were classified according to such characteristics as age, gender, mean BMI, obesity, cardiovascular events, diabetes, hypercholesterolemia, depressive symptoms, education level, BP lowering medication, and tobacco consumption.
Sample Characteristics. The participants of the research are residents of France who live in three different cities. The mean age of the monitored dwellers was 80 years.
Data Sources and Collection Measures. The data for the research were gathered and recorded with each of participant’s consent from the medical lists, questionnaires, and logbooks with BP measures. The collected data were analyzed and grouped together to show the mean number of the risk values and their connection with the masked HT.
Procedures. Pearson test with categorical variables and variance analysis with continuous variables was used to classify and analyze the data. Two adjusted and one unadjusted model were created to analyze the factors associated with masked hypertension.
Data Analysis. The results are based on the comparative statistical analysis. The baseline characteristics of the normotensive to the masked hypertensive were compared. The BP thresholds defined by the European Society of Hypertension were considered. The frequency of MHT across the different strata was analyzed.
Statistical Tests. Statistical analyses were performed using SAS statistical software version. A P value of <0,05 was considered as statistically significant.
Results. Multivariable analysis revealed that males older than 80 years with diabetes, on antihypertension medication with office SBP > 120 mm Hg are associated with higher risk of MHT.
Recommendations. The further studies should consider the French government policy regarding lowering of the cardiovascular risks in the elderly segment.
Strengths. The results encourage people to pay more attention to the elderly segment as associated with high MHT risk and, therefore, to monitor the BP more often.
Weakness. Non-proportional partition of the male and female participants, diabetic and non-diabetic representatives can lower the preciseness of the results. Although the instruction to the participants was provided, the measurements were not re-checked. The psychological state of the volunteers was neglected.
Prevalence of Hypertension and Diabetes in Elderly: Elderly Kahrizak Study
Type of study. The article “Prevalence of Hypertension and Diabetes in Elderly: Elderly Kahrizak Study” by Farshad Sharii and others presents a quantitative study of hypertension and type 2 diabetes among the Iranian elderly residents.
Location/Setting. The volunteers were found in Kahrizak Charity Foundation, Tehran, Iran. The research was held in the city of Tehran, Iran.
Concepts/Variables. The diabetes and hypertension are the primary risk factors of cardiovascular diseases. Therefore, the research provides not only the statistical data of the diseases among the population, but the frequency dependence on gender, age, weight, and psychological state. Regarding the independent variables, the scholars considered numerous risk factors. The values of systolic and diastolic pressure and cholesterol level in the blood appeared to be the dependent variables.
Theory. The framework of the research states that the risk factors of the cardiovascular diseases are hypertension and diabetes. Analysis of the dependencies of the risk factors in elderly would make it easier to prevent these diseases or the possible negative consequences.
Research Design. The observational approach to the study was based on the data obtained from 266 volunteers (totally, there are 985 elderly citizens) of Kahrizak Charity Foundation. The stratified study was held according to the approved protocol on the basis of the routine data.
Sample. Stratified ward randomized sampling was used to obtain the data from different population strata. The main aim of the study was to evaluate the prevalence of both hypertension and diabetes in the elderly according to such secondary characteristics as sex, age, body mass index, cholesterol level, and blood pressure.
Sample Size. 266 volunteers were examined, surveyed, and classified according to the groups. Five medical characteristics and three demographic ones were researched.
Sampling Methods. Scholars measured the levels of cholesterol, fasting glucose, cholesterol, triglyceride, apo-B lipoproteins, and LDL-cholesterol,. They recorded the age, history of hypertension, gender, the type of diabetes and its duration.
Sample Characteristics. All 266 volunteers were the representatives of the elderly group and the residents of Iran aged 60 years or more.
Data Sources and Collection Measures. The data for the research was gathered with the help of the Kahrizak charity foundation members and analyzed with the support of the Endocrinology and Metabolism Research Center.
Procedures. The research comprised such measurements as cholesterol, fasting glucose, triglyceride, LDL-cholesterol, apo-B lipoproteins and made a comparative analysis of the values. It was based on the comparison of the general and clinical characteristics, comparison of a mean blood pressure and fasting blood sugar in different age groups. Finally, the basic characteristics of the elderly diabetic and hypertensive residents of Kahrizak were compared separately.
Data Analysis. The results are based on the multivariable comparison and statistical analysis. The baseline characteristics of the male and female hypertensive participants were compared. The BP and cholesterol thresholds defined by the European Society of Hypertension were considered.
Statistical Tests. Statistical analyses were performed using the previous researches and findings provided by Ozkara, Prencipe, and Feng-Hwa.
Results. Comparative and statistical analyses have shown that the gender difference is influential for both diagnoses. The research revealed that the hypertension prevalence for male representatives was 55% and for the female ones - 67%. The values for diabetes 2 were defined as 21 % for men and 16% for women.
Recommendations. The study presents the influence of the dietary and lifestyle on the health of the Iran population. Therefore, it recommends investigating the appearance of the chronic diseases as the result of the health policy of the government of Iran.
Strengths. The results encourage people to pay more attention to the state of heath of the elderly residents of Iran and study the risk factors and interdependence of hypertension and diabetes 2 more deeply.
Weakness. The participants were not equally partitioned according to all risk factors. The medication consumption was not taken into consideration.
Prevalence, Awareness, Treatment and Control of Hypertension in an Elderly Population in Greece
Type of Study. The article “Prevalence, Awareness, Treatment and Control of Hypertension in an Elderly Population in Greece” by Triantafyllou and others presents a quantitative study of hypertension as a major health problem that increases with age.
Location/Setting. The volunteers aged 65 years old or more were found in the village Paliouri, Northern Greece. The research was held in collaboration with Aristotle University of Thessaloniki and the Primary Health Care Center of Kassandra.
Concepts/Variables. The arterial hypertension is one of the most frequent chronic diseases among the elderly population. Its frequency depends on such independent variables as age, BMI, and medications consumption. The dependent variable that was measured during the given research was blood pressure.
Theory. The framework of the research states that the risk factor for the cardiovascular disease is arterial hypertension. It is essential that population aging together with lifestyle is regarded as the main factors that influence the hypertension rate within the countries. In order to find out the ways to lower the hypertension rate, it is necessary to trace the connection between the demographic change and the rate of the chronic illnesses.
Research Design. The observational approach to the study was based on the data obtained from a total of 191 65-years-aged residents of the Greek village. The study was held with the informed consent of the participants on the basis of the measured data.
Sample. The community-based sampling was used to obtain the home and clinic data about the participants of the research. The main purpose of the study was to evaluate the prevalence of hypertension in the elderly and the level of its control.
Sample Size. The number of the village dwellers aged 65 years or more was 191. However, 154 of them gave consent to participate in the research. Volunteers were examined, surveyed on two occasions with an interval at least one week.
Sampling Methods. The systolic and diastolic blood pressures of each participant were measured with the help of a standard mercury sphygmomanometer. The well-trained doctor conducted research and evaluated the participants. All the value norms for BMI and BP were defined considering the European Society of Hypertension guidelines. The BP measurements and BMI were examined while all the other independent variables were taken from the patients’ clinical records.
Sample Characteristics. All the participants were the Greek dwellers of the village Paliouri. Participants were partitioned into 3 groups according to body mass index: obese (BMI ?30), overweight (BMI 25? to <30), and normal (BMI <25). The number of male and female representatives was 93 and 61 correspondingly.
Data Sources and Collection Measures. The data for the research were gathered with the help of Aristotle University of Thessaloniki and the Primary Health Care Center of Kassandra.
Procedures. Comparison of hypertension frequencies was performed with the help of Pearson’s test and Yates’ correction where appropriate, Kruskal-Wallis test for more than 2-groups variables.
Data Analysis. The results are based on the multivariable comparison and statistical analysis. The baseline characteristics of the male and female hypertensive participants were compared, and the prevalence of hypertension was calculated. Furthermore, the amount of people, who were aware of their condition, was calculated and the control level was analyzed.
Statistical Tests. Statistical Package for Social Sciences v16 was used to perform the statistical analysis. A probability value of p
Results. The research has shown that the level of hypertension among the Greek rural inhabitants is quite high – 89%. At the same time, the awareness and treatment of hypertension is high, too. The BP was poorly controlled only in 32%.
Recommendations. It is essential to make a further study about the means of local health system to increase the control rate of hypertension in elderly.
Strengths. The results indicate that hypertension is prevalent among the rural Greek elderly population. It emphasizes the importance of people’s awareness and control regarding not only hypertension, but all chronic diseases. The research was performed in spring, thus let the scholars avoid seasonal BP variations that could affect the results.
Weakness. The participants were not equally partitioned according to all risk factors. The number of volunteers was not high enough.
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