Nutritional and Clinical Profiles of Elderly People with Diabetes and Hypertension at Conakry University Hospitals

Introduction: In Guinea, there is few data on dietary practices socio-economic and clinical characteristics of elderly diabetics and hypertensives. Methods: This was a descriptive cross-sectional study of people aged 60 years and over, seen in consultation or hospitalised in Conakry University hospitals during the period from 5 September to 15 December 2023 inclusively. Results: Among the 320 subjects included in the study, there were more men (50.6%). The average age was 67 ± 7.69 years;53.43% had hypertension and 46.57% had diabetes. Sex was significantly associated with diabetes (p = 0.035). Women in the study were more affected by diabetes (55.7%), 64.4% of diabetic subjects were married and more than 64% of them had dependent children. 26.2% of diabetics were not employed;85.9% had an income;34.9% had an income of less than one million Guinean francs per month and 74.5% of them had 3 meals a day. Physical activity, 24-hour recall for lunch (p Conclusion: Effective management of diabetes and hypertension in the elderly should necessarily involve nutrition education in hospitals.

Exploring the Effects of Health Education and Chronic Disease Management Nursing in the Management of Hypertension in Elderly Patients in the Community

Objective:To explore the effects of health education and chronic disease management nursing in elderly community patients with hypertension,in order to provide scientific evidence for improving the health management level of these patients.Methods:Sixty-four elderly hypertension patients treated at this hospital between March 2022 and March 2024 were selected and randomly divided into two groups,with 32 patients in each group.One group received conventional management,designated as the control group,while the other group received a combined management strategy involving health education and chronic disease management,designated as the experimental group.The study compared the management outcomes of the two groups to evaluate the value of the combined management approach in elderly hypertensive patients in the community.Results:The study found that the experimental group showed significantly lower systolic blood pressure(SBP),diastolic blood pressure(DBP),and scores on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)compared to the control group,with statistically significant differences(P<0.05).Additionally,the experimental group demonstrated significantly higher scores in disease cognition levels regarding awareness of normal blood pressure ranges,prevention of complications,identification of high-risk factors,and healthy lifestyle practices,with statistically significant differences(P<0.05).Moreover,the experimental group showed significantly better rates of self-management behaviors,such as quitting smoking and alcohol,self-monitoring of blood pressure,dietary control,regular medication adherence,and consistent exercise,compared to the control group,with statistically significant differences(P<0.05).Conclusion:This study indicates that a combined management model integrating health education and chronic disease management effectively improves the emotional state of elderly hypertensive patients in the community,significantly enhances their disease cognition levels,and boosts their self-management abilities.Furthermore,this model can effectively lower patients’blood pressure,thereby achieving better health management outcomes for elderly hypertensive patients in the community.

Evaluation of the Effectiveness of Community Pharmacy Services on Rational Medication Use in Elderly Patients with Hypertension and Diabetes

Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.

Analysis of the Effect of Family-Centered Empowerment Model(FCEM)Health Education Through WeChat on Medication Compliance and Blood Pressure of Elderly Hypertensive Patients in Rural Areas

Objective: To validate the effectiveness of a Family-Centered Empowerment Model (FCEM) health education through WeChat on medication compliance and blood pressure among elderly hypertensive patients in rural areas. Methods: One hundred and two rural elderly hypertensive patients aged 65-80 years were selected and randomly divided into an experimental and control group of 51 each. The control group implemented conventional health education, and the experimental group implemented FCEM health education through WeChat platform for 4 consecutive weeks. The Therapeutic Adherence Scale for Hypertensive Patients (TASHP) scores and blood pressure measurements were compared between and within the two groups. Results: After the intervention, there were significant differences in medication compliance and blood pressure between the two groups (P < 0.001). In the control group, before and after the intervention, there was a significant difference in medication compliance (P < 0.001), but no significant difference in blood pressure (P > 0.05). In the experimental group, there were significant differences in medication compliance and blood pressure before and after the intervention (P < 0.001). Conclusion: The FCEM health education through an online social platform significantly improved medication compliance and led to effective blood pressure control in rural elderly hypertensive patients. Therefore, as an effective, safe, and economical model, it is also necessary to explore its effectiveness in improving health problems in other chronic diseases and other age groups.

Compliance to Medication Management and Mental Health Status of Elderly Hypertensive Patients: Basis of Educational Health Program

Objective:The study aimed to assess medication management compliance and mental health in elderly patients with hypertension.Method:The study evaluated medication compliance and mental health status of elderly hypertensive patients in China using simple random sampling.Data was collected using the Morisky Medication Compliance Questionnaire,Hospital Anxiety and Depression Scale,and a checklist.Ethical practices were strictly observed.Results:A study of 100 elderly hypertensive patients found poor drug management compliance,with female patients showing worse compliance.Female patients were more vulnerable to anxiety and depression.The study also found no significant association between gender,age,education level,marital status,living standards,and medication compliance.Barriers to medication management included food and daily necessities,lack of awareness about the importance of drug treatment,and basic family needs.The lowest-ranked barriers were lack of support from government health clinics,low income,and lack of family support.Conclusion:Based on the results,the study proposes an educational plan for elderly hypertensive patients and their families,to be evaluated and implemented by the hospital and township community service center.The plan aims to improve medication management and lifestyle modification compliance,encourage active participation,and provide access to medical and mental health clinics,support groups,and counseling services.

Effect of renal denervation for patients with isolated systolic hypertension:a systematic review and meta-analysis

BACKGROUND Renal denervation(RDN)is a promising treatment based on catheter intervention for patients with refractory hypertension.However,the effect in patients with isolated systolic hypertension(ISH)remains controversial.The aim of this meta-analysis was to determine the blood pressure lowing effect of RDN in patients with ISH compared with combined systolic/diastolic hypertension(CH)patients.METHODS PubMed,Embase,Cochrane and ClinicalTrials.gov were searched for prospective clinical studies that included RDN.The outcomes of interest were the change of 24-hour ambulatory systolic blood pressure(SBP)from baseline.We used the fixed effects model to calculate weighted mean difference(WMD)with 95%confidence interval(CI).RESULTS Six trials were included,with 1405 participants,including 597 patients with ISH and 808 patients with CH.Mean follow-up was five months.The reduction of 24-hour ambulatory SBP was significantly greater for the CH patients than the ISH patients(WMD=3.89,95%CI:2.32–5.45,P<0.0001).RDN also showed a greater reduction in office SBP in the CH patients compared to the ISH patients(WMD=10.24,95%CI:4.24–15.74,P=0.0003).And the effect was independent of age,length of follow-up,and ablation device.CONCLUSIONS RDN provides superior blood pressure control in the CH patients compared with the ISH patients,and the CH patients may be the best suitable population for which RDN is indicated.

Effect of Bushen Hemai Decoction on vascular stiffness in elderly patients with isolated systolic hypertension

Objective: To investigate the effect of Bushen Hemai Decoction on the wall stiffness of middle-aged and elderly patients with isolated systolic hypertension. Methods: A total of 126 patients with middle and old systolic hypertension were selected from March 2017 to March 2018 in our hospital. According to the random table method, there were 63 cases in the observation group and 63 cases in the control group. The control group was treated with conventional western medicine, while the observation group was treated with kidney tonifying and pulse prescription hypothyroidism on the basis of the control group. The two groups were treated for 12 weeks. The changes of blood pressure, pulse conduction velocity and endothelium-dependent vasodilation function were compared between the two groups before and after treatment. Results: the systolic pressure in the two groups was lower than that before the treatment, but the diastolic pressure was not significantly changed, and the systolic pressure in the observation group was lower than that of the control group, while the diastolic pressure was not statistically significant. After treatment, the pulse conduction velocity of the two groups was lower than that before the treatment, and the pulse conduction velocity of the observation group was lower than that of the control group after treatment. After two groups of treatment, FMD was higher than before treatment, but there was no significant change in the diameter of vascular base, and FMD in the observation group was higher than that of the control group, but there was no statistical difference between the blood vessel base diameter. The total effective rate of the observation group (93.65%) was higher than that of the control group (74.60%). Conclusion: Bushen Hemai Decoction is effective in treating isolated systolic hypertension in middle-aged and old patients, and can reduce the stiffness of patients' tube wall, which is worthy of clinical reference.

Effect of Bushen Hemai decoction on vascular stiffness in elderly patients with isolated systolic hypertension

Objective: To investigate the effect of Bushen Hemai decoction on the wall stiffness of middle-aged and elderly patients with simple systolic hypertension. Methods: The 126 middle-aged and elderly patients with simple systolic hypertension admitted to our hospital from May 2010 to May 2015 were randomly divided into control group (63 cases) and observation group (63 cases). The control group was treated with conventional Western medicine, while the observation group was treated with Bushen Hemai decoction on the basis of the control group. The two groups were treated for 4 weeks. Results: The systolic blood pressure of the two groups decreased after treatment (observation group: T=16.165, control group: T=13.537, P<0.05);the systolic blood pressure of the two groups did not change significantly after treatment (observation group: T=1.857, control group: T=0.483, P>0.05);the systolic blood pressure of the observation group was lower than that of the control group after treatment (T=16.165, P<0.05). After treatment, the level of ST segment of ECG in the two groups was lower than that before treatment (observation group: T=22.145, control group: T=11.007, P<0.05);after treatment, the level of ST segment of ECG in the observation group was lower than that in the control group (T=8.130, P<0.05). After treatment, the pulse conduction velocity of the two groups was lower than that of the control group (observation group:T=8.694, control group: T=3.944, P<0.05);after treatment, the pulse conduction velocity of the observation group was lower than that of the control group (T=5.326, P<0.05). The total effective rate of the observation group (93.65%) was higher than that of the control group (76.19%) (P<0.05). Conclusion: Bushen Hemai Decoction has a significant clinical effect on middle-aged and elderly patients with simple systolic hypertension, and can improve the stiffness of the tube wall, which is worthy of clinical reference.

Influence of irbesartan combined with low dose urokinase on treatment effect and serologic indexes in elderlyisolated systolic hypertension patients

To study the influence of irbesartan combined with low dose urokinase on treatment effect and serologic indexes in elderly isolated systolic hypertension patients. Methods: One hundred and ten cases of elderly isolated systolic hypertension patients in our hospital during January 2013–January 2016 were randomly divided into observation group with 55 cases and control group with 55 cases. Patients in observation group received irbesartan combined with low dose hydrochlorothiazide treatment and those in control group received amlodipine combined with low dose hydrochlorothiazide treatment, each lasted for 4 weeks. After 4 weeks treatment, non-invasive blood pressure and blood pressure variability indexes were measured, serum endothelial function, inflammatory factors and oxidative stress indexes were measured. Results: After 4 weeks treatment, patients systolic blood pressure (SBP), 24 h mean systolic blood pressure (24 h SBP), 24 h systolic blood pressure standard deviation (24 h SSD) were significantly lower in observation group than in control group (P<0.05);serum endothelial function index EF-1 was lower in observation group than in control group, while NO and endothelial nitric oxide synthase (eNOS) were higher in observation group than in control group (P<0.05);serum high sensitivity C-reactive protein (hs-CRP), interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor-α (TNF-α) contents were lower in observation group than in control group (P<0.05);serum oxidation index such as malondialdehyde (MDA) was lower in observation group than in control group, while antioxidant indexes such as total anti-oxidative capacity (TAC), superoxide dismutase (SOD), GSH were higher in observation group than in control group (P<0.05). Conclusions: Irbesartan combined with low dose hydrochlorothiazide can effectively reduce systolic hypertension and blood pressure variability in elderly isolated systolic hypertension patients, while optimizing the systemic inflammation and oxidative stress status.

Effect of remimazolam vs. propofol on hemodynamics during general anesthesia induction in elderly patients: Single-center, randomized controlled trial

The current study aimed to compare the effects between remimazolam and propofol on hemodynamic stability during the induction of general anesthesia in elderly patients.We used propofol at a rate of 60 mg/(kg·h)in the propofol group(group P)or remimazolam at a rate of 6 mg/(kg·h)in the remimazolam group(group R)for the induction.A processed electroencephalogram was used to determine whether the induction was successful and when to stop the infusion of the study drug.We measured when patients entered the operating room(T_(0)),when the induction was successful(T_(1)),and when before(T_(2))and 5 min after successful endotracheal intubation(T_(3)).We found that mean arterial pressure(MAP)was lower at T_(1–3),compared with T_(0) in both groups,but higher at T_(2) in the group R,whileΔMAP_(T0–T2) andΔMAP_(max) were smaller in the group R(ΔMAP_(T0–T2):the difference between MAP at time point T_(0) and T_(2),ΔMAP_(max):the difference between MAP at time point T_(0) and the lowest value from T_(0) to T_(3)).Cardiac index and stroke volume index did not differ between groups,whereas systemic vascular resistance index was higher at T_(1–3) in the group R.These findings show that remimazolam,compared with propofol,better maintains hemodynamic stability during the induction,which may be attributed to its ability to better maintain systemic vascular resistance levels.

Single-Arm Clinical Study of Combination Perindopril-Amlodipine Tablets in the Treatment of High-Altitude Hypertension

Objective:To evaluate the efficacy of combination perindopril/amlodipine tablets in patients with high-altitude hypertension who were previously unable to control their blood pressure with monotherapy.Methods:A total of 151 patients with high-altitude hypertension whose blood pressure remained inadequately controlled with previous monotherapy were enrolled in this study.All patients received an 8-week treatment with a combination of perindopril/amlodipine tablets,consisting of perindopril 10 mg/day and amlodipine 5 mg/day.Blood pressure measurements,including both diastolic and systolic pressures,were taken at baseline,and after 2,4,6,and 8 weeks of treatment.Results:After 8 weeks of treatment,there was a significant reduction in both average systolic and diastolic blood pressure compared to baseline(P<0.0001).Specifically,the average systolic blood pressure decreased by 24.45±13.75 mmHg,and the average diastolic blood pressure decreased by 13.37±8.40 mmHg.The overall heart rate showed no significant changes during the treatment period.Conclusion:A combination of perindopril/amlodipine tablets significantly improved blood pressure control in patients with high-altitude hypertension after 8 weeks of treatment.These results support the efficacy of combination perindopril/amlodipine as a viable treatment option for high-altitude hypertension.

The association between orthostatic hypertension and all-cause mortality in hospitalized elderly persons

Background Little is known about the prevalence oforthostatic hypertension （OHT） and its effect on long-term mortality in the eld- erly. We evaluated the prevalence of OHT and its effect on mortality in hospitalized elderly patients. Methods Out of 1852 patients admit- ted between 31/12/1999 and 31/12/2000 to an acute geriatric ward, 474 patients （48% males） with a mean age of 81.5 ±6.8 years were en- rolled in this study. Blood pressure （BP） was measured three times during the day in a supine and standing position. Patients with at least one increase in systolic or diastolic BP levels upon standing were diagnosed with OHT. Medical history, physical examination and laboratory parameters were retrieved from the medical records. Mortality data until 18th June 2014 were retrieved from the computerized system of the Ministry of the Interior. Results Four hundred and seven patients （86%） were diagnosed with OHT. Those without OHT had a lowerbody mass index and were more likely males, smokers, had a higher rate of Parkinson＇s disease and less congestive heart failure compared with those with OHT. Patients with OHT had a better survival rate than those without OHT （P = 0.024）. Hazard ratios （HRs） for mortality in those with OHT adjusted to age and multiple risk factors were： 0.67 [95% confidence interval （CI）： 0.51-0.87] and 0.73 （95% CI： 0.55-0.97）, respectively; a similar tendency was noticed in a sensitivity analysis by gender. Conclusion Hospitalized elderly patients with OHT had a better survival rate than those without OHT.

Hypertension in the elderly

The elderly are the most rapidly growing population group in the world.Data collected over a 30-year period have demonstrated the increasing prevalence of hypertension with age.The risk of coronary artery disease,stroke,congestive heart disease,chronic kidney insufficiency and dementia is also increased in this subgroup of hypertensives.Hypertension in the elderly patients represents a management dilemma to cardiovascular specialists and other practioners.During the last years and before the findings of the Systolic Hypertension in Europe Trial were published,the general medical opinion considered not to decrease blood pressure values similarly to other younger patients,in order to avoid possible ischemic events and poor oxygenation of the organs(brain,heart,kidney).The aim of this review article is to highlight the importance of treating hypertension in aged population in order to improve their quality of life and lower the incidence of the cardiovascular complications.

Clinical and hemodynamic profiles of elderly patients with pulmonary arterial hypertension： a single center, prospective study

Backgrounds Pulmonary arterial hypertension （PAH） was previously considered an illness that affects mostly the young, but now it is also increasingly recognized in the elderly. The aim of this study was to compare the features of elderly versus younger patients diagnosed with PAH, and to define the prognostic factors which affect their long-term survival. Methods In this prospective, single center study, the clinical, echocardiographic, hemodynamic characteristics, and the outcomes of younger （18-65 years） and elderly （〉 65 years） patients with definitive diagnosis of precapillary PAIl were compared. Results A total of 119 patients were analyzed in this study; 43 were elderly （mean age： 71.5 ± 5.5 years）, while 76 were non-elderly （mean age 44.5 ±15.2 years）. During the mean follow-up duration of 26.8 ±25.0 months, 43 deaths occurred, 17 of which were among the elderly group, with 28 among non-elderly group. Comparison of baseline parameters showed that 6 min walking distance, hemoglobin levels, pulmonary artery pressures and pulmonary vascular resistance were significantly lower; and estimated glomerular filtration rate, body mass index, E/e＇ and pulmonary capillary wedge pressure were significantly higher in the elderly group than in the younger group. Survival analysis demonstrated that the independent predictors of death were tricuspid plane annular systolic excursion （TAPSE; HR： 1.272, 95% CI： 1.079-1.499, P = 0.004） and uric acid （HR： 1.291, 95% CI： 1.042-1.600, P = 0.019） in the elderly group. In contrast, in the non-elderly group, higher brain natriuretic peptide （HR： 1.002, 95% CI： 1.001-1.004, P 〈 0.001） and higher right atrial pressure （HR： 1.128, 95% CI： 1.026-1.241, P = 0.013） values were the only parameters associated with mortality. Conclusions Our data suggest that elderly PAH patients have a unique clinical and hemodynamic profile, with totally different prognostic markers compared to younger PAH patients.

Transjugular intrahepatic porto-systemic shunt in the elderly:Palliation for complications of portal hypertension

AIM:To present a dedicated series of transjugular intrahepatic porto-systemic shunts(TIPS) in the elderly since data is sparse on this population group.METHODS:A retrospective review was performed of patients at least 65 years of age who underwent TIPS at our institutions between 1997 and 2010.Twentyfive patients were referred for TIPS.We deemed that 2 patients were not considered appropriate candidates due to their markedly advanced liver disease.Of the 23 patients suitable for TIPS,the indications for TIPS placement was portal hypertension complicated by refractory ascites alone(n = 9),hepatic hydrothorax alone(n = 2),refractory ascites and hydrothorax(n = 1),gastrointestinal bleeding alone(n = 8),gastrointestinal bleeding and ascites(n = 3).RESULTS:Of these 23 attempted TIPS procedure patients,21 patients had technically successful TIPS procedures.A total of 29 out of 32 TIPS procedures including revisions were successful in 21 patients with a mean age of 72.1 years(range 65-82 years).Three of the procedures were unsuccessful attempts at TIPS and 8 procedures were successful revisions of our existing TIPS.Sixteen of 21 patients who underwent successful TIPS(excluding 5 patients lost to follow-up) were followed for a mean of 14.7 mo.Ascites and/or hydrothorax was controlled following technically successful procedures in 12 of 13 patients.Bleeding was controlled following technically successful procedures in 10 out of 11 patients.CONCLUSION:We have demonstrated that TIPS is an effective procedure to control refractory complications of portal hypertension in elderly patients.

Influence of psychosocial factors on treatment of elderly Chinese patients with hypertension

Objective The aim of the study is to investigate the effects of psychosocial factors on the treatment of elderly patients with hypertension. Methods Atotalof 260 elderly Chinese patients with hypertension were treated with benazepril alone or benazepril combined with amlodipine for 8 weeks. The target blood pressure (BP) (both <140 mmHg systolic, SBP, and <90 mmHg diastolic, DBP) was achieved in 180 patients, who were then assigned to the well-controlled BP group;the rest were placed in the modestly controlled BP group. The psychosocial factors present in both groups were assessed by the Hamilton depression scale, Hamilton anxiety scale, life event scale and social support evaluation list before and after anti-hypertensive treatment. Results There were no significant differences in gender, mean age, hist ory of hypertension, education and smoking habit, or in SBP and DBP between the groups before treatment. Significant differences were also not found in all psychosocial factors before and after treatment in the patients. However, significant differences were found between the groups with respect to post-treatment SBP and marital status. The patients with modestly controlled BP had significantly higher scores, as well as incidents, on the depressive, anxiety, and stressful life event scales than those with well-controlled BP. The patients with well-controlled BP had significantly higher scores in tangible support, subjective support, and social support compared to the patients with modestly controlled BP. Logistic regression analysis showed the independent contribution of psychosocial factors in reaching the goal of lowering BP at treatment endpoint in these hypertensive patients. Conclusions The results suggest that psychosocial factors stand as a main barrier to achieving the BP-lowering target in the management of elderly Chinese patients with hypertension.(J Geriatr Cardiol 2007;4:202-207.)

Which prognostic factors should be used in pulmonary arterial hypertension in elderly patients？

In recent times, the prevalence of pulmonary arterial hypertension creased prevalence of hypertension, diabetes, obesity, arterial stiffness, （PAH） is more commonly seen among elderly populations. The inas well as diastolic dysfunction, may cause endothelial dysfunction and affect pulmonary vasculature. Furthermore, older patients have certain differences in clinical characteristics and outcomes. In this article the special characteristics of aging in PAH patients have been reviewed, while the risk predictors of elderly patients are also discussed.

The Survey of Self-Regulation Behaviors and Related Factors in Elderly with Hypertension in South-East of Iran

Hypertension is one of the most important risk factors for heart diseases today. The effect of hypertension in the elderly is higher than other age groups and it may lead to changes in their quality of life. By the increase of age, the amount of self-care behaviors of patients with hypertension decreased. Therefore, control and self-care behaviors are so important. This study has been conducted to study self-regulation behaviors and Associated Factors in elderly patients with hypertension. This study was a cross sectional, descriptive analytic study, which was conducted using multistage sampling on the elderly 60 years and above with hypertension. The sample size was calculated 365 and the final sample size of 380 people was considered by possible losses. The instruments include of demographic and self-regulatory behaviors questionnaire. The results showed that self-regulation of behavior was 42.3% of the total score. In terms of quality, only 7.4% of the elderly had good behavior, 46.6% of poor performance, and the rest were mediocre performance. Age (p = 0.03), gender (p = 0.02), education (p = 0.001), income level (p = 0.03) and marital status (p = 0.001) significantly associated with behaviors of self-regulation. The results generally indicate unfavorable self-regulation of elderly patients with hypertension. Some variables such as gender, age, marital status, education and income levels were associated with these behaviors. So paying attention to the education of the elderly in care centers is essential.

Hypertension knowledge in urban elderly patients:compari-son between adherents to traditional Chinese medicine and Western medicine

Objective To compare knowledge about hypertension between elderly Chinese urban patients with preferences for either traditional Chinese medicine (TCM) or Western medicine (WM). Methods Elderly (≥ 65 years old) patients with hypertension who prefer TCM treatment (n=112) or WM (n=126) were questioned about hypertension. Their answers were compared. Results Only 32.6% of participants correctly identified hypertension as a main risk factor of coronary heart disease and stroke, 22.3% of patients answered that the main purpose of hypertension control was preventing cardiovascular disease. Other major reasons for these patients to seek medical treatment for their hypertension included: persuasion by physicians or their family members (21.6%), alleviating symptoms such as headache and dizziness (16.8%), lowering blood pressure without knowing specific reason (12.4%). The predictors for poor knowledge of hypertension were similar irrespective of preference for WM or TCM treatment, and included those with lower levels of education and older age. Television and newspaper (46.8%) were the most frequent sources of hypertension information for both groups. Among those who preferred TCM treatment, "TCM has fewer side effects than WM" and"TCM cures disease while WM only alleviates symptoms" were common beliefs held. Conclusion This study shows that knowledge of hypertension is similar among Chinese urban patients with preferences for either WM or TCM treatment and that misunderstandings about hypertension are common among the elderly patients. In order to control hypertension effectively, public health education is necessary. This should target those with a lower level of education and older age.

How to select the appropriate candidate of pulmonary arterial hypertension： specific therapy in elderly patients with pulmonary hypertension

Recent reports from pulmonary arterial hypertension （PAH） registries suggest that the mean age at diagnosis is increasing in a growing proportion of elderly patients. The combination of several reasons such as aging popula- tion, increase in life expectancy, growing PAH awareness of physicians and patients, and availability of more treatment options could explain the changing picture of PAH. PAH should be considered as an emerging entity in the elderly.