期刊论文详细信息
Системные гипертензии
Risk factors for falls in patients with arterial hypertension
Anton V Naumov1  Victoriya I Moroz1  Olga N Tkacheva2  Natalia O Khovasova2 
[1] Russian Clinical and Research Center of Gerontology of Pirogov Russian National Research Medical University;Pirogov Russian National Research Medical University;
关键词: falls;    fractures;    elderly people;    disability;    mortality;    arterial hypertension;    orthostatic hypotension;   
DOI  :  10.26442/2075082X.2019.4.190649
来源: DOAJ
【 摘 要 】

Falls are a serious multi-factorial problem faced by the elderly persons which is associated with serious complications, loss of functional autonomy, disability and death. One of the common comorbidities among the elderly persons is arterial hypertension (AH) which increases the risk of falls. Aim. To study the risk factors for falls among patients with AH. Materials and methods. Examined 155 patients of geriatric department with the presence of at least one fall in the last year: 133 (85.8%) women (75,29±8.31 years) and 22 (14.2%) men (79,14±4.64 years). Risk of falls and risk factors of falls were assessed in patients with AH. Results. 148 (95.5%) patients had AH. The most common risk factors for hypertension in the elderly were atherosclerosis and decreased physical activity. Target organ lesions of varying severity were observed in all patients. In 25.7% of cases, BP figures outside the target values were noted. 18 (12.2%) patients received hypotensive therapy irregularly. On avera-ge, at admission, patients received of 2.06±0.63 anti-hypertensive drug. The frequency of falls in patients with hypertension made up 2.59±2.2, two or more falls happened in 91 persons (61.5%). According to the self-assessment risk of falls scale 131 (88.5%) patients had a high risk of falls. A high risk of falling in hospital (on the Morse scale) was identified in 63 (42.6%) patients. The most common risk factors for falls in patients with AH were previous falls in anamnesis, sensory de-ficit, imbalance, osteoarthritis. The CGA results demonstrate that patients with hypertension with blood pressure below the target values in comparison with the target and even high numbers of blood pressure have a higher prevalence of frailty, worse indicators of functional status, higher incidence and high risk of falls on the Morse scale. Conclusion. The most common risk factors for falls among patients with AH are previous falls in anamnesis, sensory deficit, imbalance, osteoarthritis. For patients with hypertension, low blood pressure is a predictor of high risk of falls and a worse prognosis. When blood pressure is below the target, there is a higher prevalence of frailty and worse indicators of functional status, which is a poor prognostic sign for the elderly.

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