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.

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.

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.

Meta-Analysis the Quality of General Practitioners Management for Elderly Patients with Hypertension in China

Background: Among Chinese adults aged 35 - 75 years, nearly half have hypertension and the prevalence of hypertension is increased with age. But older patients with high systolic pressure and high pulse pressure could not be cured, and will have greater cardiovascular morbidity. This study aims to evaluate the effectiveness of general practitioners (GP) management for Chinese elderly hypertension, and explore reasonable and effective blood pressure management pattern. Methods: We searched the published literature for randomized controlled trials designed to improve blood pressure with community care management delivered by general practitioners or nurses, compared with usual care. Major outcome measures were systolic and diastolic blood pressure;the percentage of patients whose blood pressures are under control with community care management and Revman 5.3 was used in this study. Results: Pooled data from all 13 researches showed a lower outcome diastolic blood pressure (SMD = &minus;0.95, 95% CI (&minus;1.23, &minus;0.67)) and systolic blood pressure (SMD = &minus;1.17, 95% CI (&minus;1.52, &minus;0.81)) respectively in favor of community management. Pooled data from all 11 researches showed a higher percentage of patients with blood pressure under control in favor of community management (OR = 3.85, 95% CI (1.58, 9.37)) and the difference between treatment group and control group on blood pressure control ratio had statistical significance (Z = 2.97, P Conclusions: General practitioners’ management in Chinese elderly hypertension is effective, and complies with the advanced hypertension management guidelines. The multi-patterns are supposed to adopt community blood pressure monitoring and team-based general practitioners.

Effects of a Graded Brisk Walking Test with Different Intensity Levels on Elderly Patients with Essential Hypertension:A Prospective Study in Shanghai,China

Background:This study aimed to clarify the effects of a Graded Brisk Walking Test(GBWT)program on blood pressure(BP)control in elderly patients with essential hypertension and to determine its appropriate degree of intensity for elderly people.Methods:In total,421 out of 620 participants were randomly sampled from a community health center in Shanghai,China.Among them,200 and 221 patients were assigned to the intervened and control groups,respectively.They were all treated with the GBWT program for 8 weeks,16 weeks,and 24 weeks.Results:Based on ANOVA,there was no significant time main effect,condition main effect,or time by condition interaction both in heart rate and body mass index indicators(P>0.05).There were significant condition main effects,time by condition interaction,or time main effects in blood pressure(F=21.875,33.457,65.342,respectively;All P<0.05).After the intervention,significant differences in systolic blood pressure(SBP)and diastolic blood pressure(DBP)values were also observed in the two groups(P<0.05);the average values of the baseline and second phases of the intervention group were significantly lower than those of the control group(P<0.05).Significant differences in blood pressure values after the first two phases were also observed when compared with those before the intervention.Similarly,a significant difference in the first phase and second phase was also found between the BP group and intervention group.However,after the third phase(24 weeks,high-intensity exercise),no significant differences existed both in SBP and DBP groups compared with those before the intervention(P=0.07).Conclusion:GBWT is an effective exercise prescription to mitigate the essential hypertension in elderly Chinese patients,and the intensity,walking distance,and target number of steps can be adjusted according to the age of the patients.

Health Status of Urban Medium-Low-Income Elderly at the Community

Background: Nonagenarians are uncommon in our population. The study aim was to profile physical mobility, declared health problems, hypertension and diabetes frequency, awareness, treated and good control in urban low-income elders. Method: The study had cross-sectional design in population sample. Subjects were urban men and women older than 59 years at the medium low income stratum at a developing country. Survey was carried out from October 2008 to October 2009. All elder dwellers in randomly selected houses were surveyed;clinical exam after consent. Good Control: Systolic/Diastolic Results: There were 162 elders, 53 (32.7%) were male, 99 (61.1%) were younger than 70 years. Forty nine (30.2%) had impaired mobility;among them 20 (55.6%) were bed or home restricted, and 29 (44.4%) needed help to go out. Unstable health condition was found in 36 (22.2%), with significantly more men 19 (52.8%) vs 34 (27.0%), X2 = 8.5, df1, P 0.05. The frequency, proportions for: known diagnosis, on treatment, and good control were 75 (69.4%), 55 (73.3%), 45 (60.0%) and 12 of 45 (26.7%) for hypertension;53 (49.1%), 47 (88.7%), 42 (79.2%) and 9 of 42 (21.4%) for diabetes. The most frequent unstable conditions were cardiovascular. Conclusions: Data suggest unstable health no association with the oldest old. The small proportion in good control of Diabetes and/or hypertension could explain the large frequency of elders with unstable health and prevention of reaching nonagenarian age.

Community Health Management and Nursing Strategies for Elderly Hypertension

Objective:To explore the therapeutic effects of community health management and nursing strategies for elderly hypertensive patients.Methods:A total of 64 elderly hypertensive patients who were treated in our hospital from March 2020 to March 2021 were selected.The control group took conventional care and guidance.The research group carried out community health management and nursing strategy guidance on the basis of the control group.Then compare the blood pressure levels of the two groups of patients before and after nursing and the patients’satisfaction with nursing.Results:Through comparison,it can be seen that the diastolic and systolic blood pressure levels of the study group and the control group are not significantly different before nursing.After nursing,the diastolic blood pressure of the patients in the study group was 81.22.1 mmHg and the systolic blood pressure was 126.58.7 mmHg.The diastolic blood pressure of the control group was 90.55.4 mmHg and the systolic blood pressure was 136.412.9 mmHg.There are obvious differences in the comparison of the two sets of data.By comparing the two groups of patients’satisfactions with nursing care,it can be seen that among the 32 patients in the study group:31 were very satisfied and basically satisfied,with a satisfaction rate of 96.87%.Among the 32 patients in the control group,28 were very satisfied and basically satisfied,with a satisfaction rate of 87.5%.The data of the two groups of patients are clearly comparable.Conclusion:Through community health management and nursing strategies,the satisfaction and treatment effect of elderly hypertensive patients can be improved,thereby contributing to the recovery of patients.

A poor performance in comprehensive geriatric assessment is associated with increased fall risk in elders with hypertension： a cross-sectional study

Background Fall and serious fall injuries have become a major health concern for elders. Many factors including blood pressure and anti-hypertensive medication application were reported as hazards of fall. The purpose of this study was to determine if age related systemic functional decline related with increased fall risks in elderly patients with hypertension. Methods A total of 342 elderly hypertension patients （age 79.5 ＋ 6.7 years, male 63.8%） were recruited to the study. Comprehensive geriatric assessment （CGA）, including measurements about activity of daily living （ADL）, nutrition, cognition, depression, numbers of prescription medication and number of clinical diagnosis, was conducted to evaluate the physical and mental status of each participants. Fall risk was evaluated by Morse fall scale, Tinetti perform- ance oriented mobility assessment （POMA） and history of fall in the recent years. Participants were grouped into tertiles according to CGA score. Correlation between CGA and fall risk was analyzed through SPSS 18.0. Results Participants with higher CGA score were likely to be older, had a lower body mass index （BMI）, and a higher prevalence of cardiovascular disease, chronic obstructive pulmonary disease （COPD）, cerebrovascular disease and osteoarthropathia. Participants in higher tertile of CGA score got increased prevalence of fall risk than those in lower tertile （P 〈 0.01 T3 vs. T1, P 〈 0.01 T3 vs. T2）. Correlation analysis and regression analysis showed significant association between CGA and Morse fall scale （P 〈 0.001）, as well as CGA and POMA （P 〈 0.001）. Meanwhile, CGA components also showed co-relationships with increase fall risks. After adjusting age, BMI, benzodiazepine use, cardiovascular disease, cerebrovascular disease, COPD and osteoarthropathia, both history of fall in the recent year and rising Morse fall scale were significantly associated with ADL im- pairment （OR： 2.748, 95%CI： 1.598-4.725）, （OR： 3.310, 95%CI： 1.893-5.788）. Decreased Tinetti POMA score was associated with Mini-Mental State Examination （MMSE） （OR： 4.035, 95%CI： 2.100-7.751）, ADL （OR： 2.380, 95%CI： 1.357-4.175） and shortened MNA form （MNA-SF） impairment （OR： 2.692, 95%CI： 1.147-6.319）. Conclusions In elderly adults with hypertension, impaired physical and mental function is associated with increased fall risk. Further study is required to investigate possible mediators for the association and effec- tive interventions.

Availability and social determinants of community health management service for patients with chronic diseases:An empirical analysis on elderly hypertensive and diabetic patients in an eastern metropolis of China

Objective:This study aimed to determine the availability of community health management services and the relevant social determinants for elderly patients with chronic diseases.Methods:All data were obtained from the 2013 random sampling household survey on an elderly population conducted by the School of Public Health of Peking University in an eastern metropolis in China.Information from the database of the above survey involving 1495 hypertensive or diabetic patients>60 years of age,as representatives of the city,were included.The study described the availability of follow-up services by community doctors among elderly hypertensive and diabetic patients during the 12 months before the survey.An ordinal multinomial logistic regression model was used to conduct the analysis on the influence of socio-economic background upon such availability.Results:Eighty-one percent of hypertensive patients and 84.7%of diabetic patients had not received any follow-up service from community doctors within 12 months prior to the survey.Among elderly hypertensive patients,those registered as non-agricultural household members,those with high and above-average income,as well as management personnel of government agencies,enterprises,and social programs have a greater chance of accepting follow-up service by community doctors because of their relatively higher socio-economic rankings.Among elderly diabetic patients,such socio-economic factors had no significant influence on the availability of the follow-up service for chronic diseases.Conclusion:The coverage of community health management services for elderly hypertensive and diabetic patients needs improvement.More effort should focus on promoting the availability of community health management services for elderly hypertensive patients,especially those with lower socio-economic status.

Hypertension in the elderly： insights from recent research

Hypertension is a leading cause of mortality and morbidity around the world and,prevalence of hypertension is increasing with aging.Hypertension in the elderly is associated with increased occurrence rates of sodium sensitivity,isolated systolic hypertension,and ＇white coat effect＇.Arterial stiffness and endothelial dysfunction also increase with age.These factors should be considered in selecting antihypertensive therapy.The prime objective of this therapy is to prevent stroke.The fmdings of controlled trials show that there should be no cut-off age for treatment.A holistic program for controlling cardiovascular risks should be fully discussed with the patient,including evaluation to exclude underlying causes of secondary hypertension,and implementation of lifestyle measures.The choice of antihypertensive drug therapy is influenced by concomitant disease and previous medication history,but will typically include a thiazide diuretic as the first-line agent;to this will be added an angiotensin inhibitor and/or a calcium channel blocker.Beta blockers are not generally recommended,in part because they do not combat the effects of increased arterial stiffness.The hypertension-hypoten-sion syndrome requires case-specific management.Drug-resistant hypertension is important to differentiate from faulty compliance with medication.Patients resistant to the third-line drug therapy may benefit from treatment with extended-release isosorbide mononitrate.A trial of spironolactone may also be worthwhile.

氨氯地平联合依那普利治疗老年高血压疗效观察

目的:观察苯磺酸氨氯地平片和马来酸依那普利片联合使用对老年高血压患者的治疗效果。方法:选取2019年2月—2022年1月上海市浦东新区陆家嘴社区卫生服务中心诊治的150例老年高血压病患者,依据随机数字表法,将患者分为对照组(n=75)和观察组(n=75)。给予观察组患者苯磺酸氨氯地平片和马来酸依那普利片联合治疗,给予对照组患者单纯苯磺酸氨氯地平片进行治疗,治疗8周后,观察两组患者的药物疗效及安全性。结果:治疗后,观察组血压达标率89.33%,高于对照组的72.00%,差异有统计学意义(χ^(2)=7.224,P<0.05);观察组患者收缩压、舒张压及平均动脉压水平均明显低于对照组,差异均有统计学意义(t值分别为9.029、8.229、7.719,P值均<0.05);观察组一氧化氮水平为(39.54±4.30)μmol/L,明显高于对照组的(33.84±4.17)μmol/L,差异有统计学意义(t=8.241,P<0.05);观察组血管紧张素Ⅱ、内皮素水平分别为(50.19±7.13)ng/dl、(63.12±7.94)ng/L,明显低于对照组的(57.34±6.22)ng/dl、(74.85±8.83)ng/L,差异均有统计学意义(t值分别为6.544、8.555,P值均<0.05)。对照组不良反应发生率为13.33%,明显高于观察组的4.00%,差异有统计学意义(χ^(2)=4.127,P<0.05)。结论:苯磺酸氨氯地平片和马来酸依那普利片联合治疗老年高血压患者能够实现协同降压效果,可以显著改善患者血管活性物质,提高血压控制达标率,且其药物不良反应发生率、有效性及安全性明显优于单独使用氨氯地平。

Management of chronic heart failure in the older population

Chronic heart failure （CHF） is the leading cause of hospitalization for those over the age of 65 and represents a significant clinical and economic burden. About half of hospital re-admissions are related to co-morbidities, polypharmacy and disabilities associated with CHF. Moreover, CHF also has an enormous cost in terms of poor prognosis with an average one year mortality of 33%–35%. While more than half of patients with CHF are over 75 years, most clinical trials have included younger patients with a mean age of 61 years. Inadequate data makes treatment decisions challenging for the providers. Older CHF patients are more often female, have less cardiovascular diseases and associated risk factors, but higher rates of non-cardiovascular conditions and diastolic dysfunction. The prevalence of CHF with reduced ejection fraction, ischemic heart disease, and its risk factors declines with age, whereas the prevalence of non-cardiac co-morbidities, such as chronic renal failure, dementia, anemia and malignancy increases with age. Diabetes and hypertension are among the strongest risk factors as predictors of CHF particularly among women with coronary heart disease. This review paper will focus on the specific consideration for CHF assessment in the older population. Management strategies will be reviewed, including non-pharmacologic, pharmacologic, quality care indicators, quality improvement in care transition and lastly, end-of-life issues. Palliative care should be an integral part of an interdiscipli-nary team approach for a comprehensive care plan over the whole disease trajectory. In addition, frailty contributes valuable prognostic in-sight incremental to existing risk models and assists clinicians in defining optimal care pathways for their patients.

Blood Pressure Targets in the Hypertensive Elderly

Objective： Hypertension is an important risk factor of cardiovascular disease and increases mortality in the elderly. However, the available medical evidences are both inconsistent and insufficient regarding establishing credible and useful blood pressure （BP） targets in the hypertensive elderly. This review summarizes the existing evidences used for establishing optimal BP targets for this patient population and points out some data inconsistencies which have added to the uncertainty. Data Sources： We conducted a search for the articles published in English in the PubMed database up to March 2017, with the keywords ＂hypertension,＂ ＂elderly,＂ ＂blood pressure,＂ and ＂antihypertensive.＂ Study Selection： Articles that related to BP targeting in the hypertensive elderly were selected for this review. Results： The selected studies indicated that antihypertensive therapy can substantially reduce the risk of cardiovascular events and mortality, for a subset of the elderly （60 years or older） with systolic BP 〉 160 mmHg. Studies regarding more strict targets yielded mixed findings. For the very old and frail patients （80 years or older）, there is a lack of evidence that optimal BP targets and intensive antihypertensives are helpful but in fact may be harmful. Conclusions： There are solid evidences that patients who are 60-80 years old and in good health have benefited from lowering their BP to below 150/90 mmHg. If well tolerated, the BP target can be further lowered to below 140/90 mmHg. However, for the very old and frail, individualized and careful assessment is crucial. Antihypertensive treatment should be cautious and the adverse effect of drugs requires close monitoring as such treatment can be counterproductive.

80岁以上老年人单纯收缩期高血压与颈动脉硬度

目的:研究80岁以上高龄老年人单纯性收缩期高血压(ISH)与颈动脉僵硬度的关系。方法:采用高分辨率超声仪对80岁以上高龄老年人单纯收缩期高血压患者25例(单纯收缩期高血压组)、收缩期/舒张期均高的高血压患者24例(收缩期/舒张期高血压组)及正常血压者20例(正常对照组)进行检测,测量其颈动脉收缩期和舒张期内径,并计算颈动脉紧张度、扩张性和僵硬度,而后对3组之间进行差异显著性比较及相关因素分析。结果:颈动脉紧张度在单纯收缩期高血压组低于收缩期/舒张期高血压组(P<0.05),与正常对照组比较差异无统计学意义(P>0.05)。颈动脉扩张性在单纯收缩期高血压组和收缩期/舒张期高血压组明显低于正常对照组(P<0.01);颈动脉僵硬度在单纯收缩期高血压组明显高于正常对照组和收缩期/舒张期高血压组(P<0.01);差异均有统计学意义。结论:80岁以上高龄老年人单纯性收缩期高血压患者颈动脉僵硬度增加,颈动脉扩张性降低,临床上应重点关注对单纯性收缩期高血压患者的检查和治疗。

替米沙坦治疗老年性高血压合并糖耐量低减(IGT)的疗效观察

目的探讨替米沙坦治疗老年性高血压合并IGT的临床效果。方法将临床诊断为高血压合并IGT老年患者共400例作为研究对象,年龄45～78岁,平均年龄(64.1±12.3)岁。随机分为试验组和对照组,试验组(N=200例)给予替米沙坦治疗,对照组(N=200例)给予苯磺酸氨氯地平治疗。随访2年,定期测量收缩压、心率、空腹和餐后2h血糖等。总结心肌梗死、脑卒中、心绞痛、心力衰竭、新发2型糖尿病的发生率。结果试验组SBP和FBG等指标与对照组相比统计学无显著性差异(P>0.05);HR和2hPBG显著低于对照组(P<0.05)。试验组心脑血管并发症发生率低于对照组(P<0.05)。结论替米沙坦治疗原发性高血压合并IGT患者,能在有效控制血压的同时更显著的控制餐后2h血糖,从而减少相关心脑血管事件的发生,改善患者生活质量。

护理干预对老年肥胖高血压患者糖代谢的影响

目的探讨护理干预对伴糖耐量异常的肥胖高血压病患者的影响。方法2003年起在我院门诊就诊的高血压且伴糖耐量异常的老年患者176例，分为干预组80例和对照组96例，经3～3．5年的护理干预及跟踪随访，将两组患者基本状况、临床生化指标、依从性及新发生糖尿病和心血管病的发生情况进行比较。结果干预组的依从性均明显高于对照组（P〈0．01），在体重指数、腰围、餐后2h血糖及胰岛素、胰岛素抵抗指数方面均较对照组明显降低（P〈0．01）；干预组2型糖尿病和心血管病的发生率也明显低于对照组。结论有效的护理干预对伴糖耐量异常的肥胖高血压病患者有着显著作用，有利于病情的控制，防止其进一步的发展，并能有效是降低2型糖尿疾病和心血管病的发生。

双肺通气对胸腔镜联合腹腔镜下食管癌根治术高血压老年患者的影响

目的观察双肺通气对胸腔镜联合腹腔镜下食管癌根治术高血压老年患者的影响。方法随机选择自2016年7月至2016年12月在我院因食管癌根治术的老年患者68例,所有患者均进行术前谈话,将患者随机分为观察组(单腔气管插管双肺通气组,n=37例)和对照组(双腔气管插管单肺通气组,n=31例)。全凭静脉诱导与维持麻醉。记录比较两组患者麻醉诱导前(T_0)、手术开始60 min(T_1)和手术结束后双肺通气30 min(T_2)的各项血流动力学指标:有创平均动脉压(MAP)、每搏量变异度(SVV)、心脏指数(CI)、心率(HR)、每搏输出量(SV)、外周动脉心排血量(CO)、中心静脉压(CVP)以及患者手术后的预后情况。记录两组患者T_0、T_1、T_2三个不同时间中心静脉血肿瘤坏死因子TNF-α、白细胞介素-8(IL-8)、IL-10的浓度。结果两组患者在麻醉诱导前的各项血流动力学指标均无显著差异,观察组在T_1,CI、CO、SV、MAP大于对照组,SVV、HR观察组小于对照组;观察组在T_2,MAP、HR小于对照组(P<0.05)。观察组在T_1、T_2,TNF-α、IL-8的浓度低于对照组;在T_1、T_2,IL-10高于对照组(P<0.05)。两组患者TNF-α、IL-8、IL-10在T_0无显著差异(P>0.05)。患者肺部感染、术后咽痛、声音嘶哑和住院天数,观察组均小于对照组(P<0.05)。结论双肺通气可维持老年高血压患者手术中血流动力学的稳定,并对患者的愈后产生良好的影响。

运动疗法对老年Ⅰ级高血压的作用

〔目的〕探讨太极拳运动对老年I级高血压的影响及作用机制。〔方法〕选取经医院确诊的老年I级高血压患者120例,随机将其中60例常规服用降压药(卡托普利)的患者设为对照组;将60例太极拳运动治疗的患者设为实验组,即在专业人士指导下采用单纯陈氏太极拳运动治疗2 mon。〔结果〕经过对比观察,太极拳运动对老年I级高血压患者的降压效果显著(P<0.05),与之前未进行太极拳运动并常规服药的患者降压效果等同。〔结论〕太极拳运动对老年I级高血压治疗效果良好,值得推广应用。

224例老年高血压患者心理状况调查分析

目的 了解社区老年高血压患者的心理状况，为实施科学的心理干预措施提供指导。方法 2002年1月-2005年1月随机抽取在我院就诊的老年高血压患者224例，用Zung抑郁自评量表（SDS）进行询问和评估调查。结果 老年高血压患者与普通人群SDS值的差异有统计学意义（P＜0．01）；不同性别、婚姻状况及家庭状况患者SDS值的差异有统计学意义（P＜0．01）；不同患病程度高血压患者SDS值的差异无统计学意义（P＜0．05）。结论 老年高血压患者抑郁状态的发生率高，医护人员应加强其心理干预。缺乏高血压防治知识、主动测血压、规律服药的患者较多，应加强此方面的健康教育。

舒芬太尼对老年高血压手术患者插管应激反应临床研究

目的比较舒芬太尼和芬太尼对老年高血压患者气管插管应激反应的影响。方法拟行择期下腹部手术患者32例随机分为舒芬太尼组和芬太尼组,两组患者在麻醉诱导时分别应用舒芬太尼和芬太尼,观察两组患者诱导前、插管前、插管后即刻以及插管后3 min等时点的收缩压(DBP)、舒张压(SBP)、心率(HR)值以及去甲肾上腺素(NE)、肾上腺素(E)浓度。结果插管后即刻和插管后3 min时点舒芬太尼组SBP、DBP值明显低于芬太尼组(P<0.05),两组患者NE和E比较差异明显(P<0.05)。结论舒芬太尼用于老年高血压患者的麻醉诱导更能抑制气管插管引起的应激反应。