Exploring the Dynamics of Week-to-Week Blood Pressure in Nursing Home Residents Before Death.
Exploring the Dynamics of Week-to-Week Blood Pressure in Nursing Home Residents Before Death.
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探索疗养院居民生前每周血压的动态。
DOI：
10.1093/ajh/hpab142
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发表时间：
2022
影响因子：
3.2
通讯作者：
Odden,MichelleC
中科院分区：
文献类型：
--
作者：
Graham,LauraA;Lee,SeiJ;Steinman,MichaelA;Peralta,CarmenA;Rubinsky,AnnaD;Jing,Bocheng;Fung,KathyZ;Odden,MichelleC
糖尿病伴随着许多动态生理过程的整体失调，包括与血压（BP）相关的生理过程。虽然逐年血压变化与心血管事件和死亡率相关，但没有研究通过更频繁的血压评估来检查这一趋势。我们的研究目标是采取下一步检查周到周BP动态模式，变异性和复杂性-before death. METHODS使用回顾性研究设计，我们评估了BP动态在6个月前死亡的长期疗养院居民之间的2006年10月1日和2017年9月30日。在调整昼夜变化后，使用SD和均方误差表征变异性。复杂性（即，趋势中的新信息量）使用香农熵（比特）进行检查。我们确定了17，953名疗养院居民（98.0%为男性，82.5%为白色，平均年龄80.2岁，平均血压125.7/68.6 mm Hg）。尽管随着时间的推移收缩压周间血压有轻微下降趋势（δ = 7.2 mm Hg），但周间复杂性在死亡前6个月内没有变化（δ = 0.02 bits）。平均每周血压变异性稳定，直到生命的最后3 - 4周，此时收缩压和舒张压的变异性增加了30%。与BP变异性相关的因素包括平均每周收缩压/舒张压，天在疗养院，天在医院，和抗高血压药物的变化。CONCLUSIONSWeek-to-week BP变异性大幅增加，在生命的最后一个月，但复杂性并没有改变。护理模式的变化可能会导致血压变异性随着死亡的临近而增加。
BACKGROUNDAging is accompanied by an overall dysregulation of many dynamic physiologic processes including those related to blood pressure (BP). While year-to-year BP variability is associated with cardiovascular events and mortality, no studies have examined this trend with more frequent BP assessments. Our study objective is to take the next step to examine week-to-week BP dynamics—pattern, variability, and complexity—before death.METHODSUsing a retrospective study design, we assessed BP dynamics in the 6 months before death in long-term nursing home residents between 1 October 2006 and 30 September 2017. Variability was characterized using SD and mean squared error after adjusting for diurnal variations. Complexity (i.e., amount of novel information in a trend) was examined using Shannon’s entropy (bits). Generalized linear models were used to examine factors associated with overall BP variability.RESULTSWe identified 17,953 nursing home residents (98.0% male, 82.5% White, mean age 80.2 years, and mean BP 125.7/68.6 mm Hg). Despite a slight trend of decreasing systolic week-to-week BP over time (delta = 7.2 mm Hg), week-to-week complexity did not change in the 6 months before death (delta = 0.02 bits). Average weekly BP variability was stable until the last 3–4 weeks of life, at which point variability increased by 30% for both systolic and diastolic BP. Factors associated with BP variability include average weekly systolic/diastolic BP, days in the nursing home, days in the hospital, and changes to antihypertensive medications.CONCLUSIONSWeek-to-week BP variability increases substantially in the last month of life, but complexity does not change. Changes in care patterns may drive the increase in BP variability as one approaches death.
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成人生活过程中的血压跟踪：弗雷明汉心脏研究中的模式和相关性。
DOI：
10.1161/hypertensionaha.112.201780
发表时间：
2012-12
期刊：
Hypertension (Dallas, Tex. : 1979)
影响因子：
--
作者：
Cheng S;Xanthakis V;Sullivan LM;Vasan RS
通讯作者：
Vasan RS
影响因子：
2.9
作者：
LIPSITZ, LA
通讯作者：
LIPSITZ, LA
DOI：
10.1126/sageke.2004.16.pe16
发表时间：
2004-04
期刊：
Science of aging knowledge environment : SAGE KE
影响因子：
--
作者：
L. Lipsitz
通讯作者：
L. Lipsitz
影响因子：
3.2
作者：
Suchy-Dicey, Astrid M.;Wallace, Erin R.;Longstreth, W. T., Jr.
通讯作者：
Longstreth, W. T., Jr.
DOI：
10.1093/gerona/57.3.b115
发表时间：
2002-03-01
影响因子：
5.1
作者：
Lipsitz, LA
通讯作者：
Lipsitz, LA