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논문 기본 정보

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학술저널
저자정보
Choi Jung-Yeon (Departmentof Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.) Lee Hae-Young (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.) Lee Ju-Hee (Departmentof Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.Department of Cardiology and Cardiocerebrovascular Center, Chungbuk National University Hosp) Hong Youjin (Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.Cancer Research Institute, Seoul National University, Seoul, Korea.Integrated Major in Innovati) Park Sue K. (Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.Cancer Research Institute, Seoul National University, Seoul, Korea.Integrated Major in Innovati) Ryu Dong Ryeol (Division of Cardiology, Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea.) Lee Jang Hoon (Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.) Hwang Seokjae (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea.) Kim Kye Hun (Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.) Lee Sun Hwa (Division of Cardiology, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea.) Kim Song-Yi (Division of Cardiology, Department of Internal Medicine, Jeju National University Hospital, Jeju, Korea.) Park Jae-Hyeong (Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.) Kim Sang-Hyun (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul Nati) Kim Hack-Lyoung (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul Nati) Choi Jung Hyun (Division of Cardiology, Department of Internal Medicine, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.) Kim Cheol-Ho (Departmentof Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.) Cho Myeong-Chan (Departmentof Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.Department of Cardiology and Cardiocerebrovascular Center, Chungbuk National University Hosp) Kim Kwang-il (Departmentof Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.39 No.10
발행연도
2024.3
수록면
1 - 12 (12page)
DOI
10.3346/jkms.2024.39.e84

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Background: As the prevalence of hypertension increases with age and the proportion of the older population is also on the rise, research on the characteristics of older hypertensive patients and the importance of frailty is necessary. This study aimed to identify clinical characteristics of older hypertension in Korea and to investigate these characteristics based on frailty status. Methods: The HOW to Optimize eLDerly systolic BP (HOWOLD-BP) is a prospective, multicenter, open-label, randomized clinical trial that aims to compare intensive (target systolic blood pressure [SBP] ≤ 130 mmHg) with standard (target SBP ≤ 140 mmHg) treatment to reduce cardiovascular events in older hypertensive Korean patients aged ≥ 65 years. Data were analyzed through a screening assessment of 2,085 patients recruited from 11 university hospitals. Demographic, functional (physical and cognitive), medical history, laboratory data, quality of life, and medication history of antihypertensive drugs were assessed. Results: The mean age was 73.2 years (standard deviation ± 5.60), and 48.0% (n = 1,001) were male. Prevalent conditions included dyslipidemia (66.5%), obesity (body mass index ≥ 25 kg/m2 , 53.6%), and diabetes (28.9%). Dizziness and orthostatic hypotension were self-reported by 1.6% (n = 33) and 1.2% (n = 24), respectively. The majority of patients were on two antihypertensive drugs (48.4%), while 27.5% (n = 574) and 20.8% (n = 433) were on 1 and 3 antihypertensive medications, respectively. Frail to pre-frail patients were older and also tended to have dependent instrumental activities of daily living, slower gait speed, weaker grip strength, lower quality of life, and lower cognitive function. The frail to pre-frail group reported more dizziness (2.6% vs. 1.2%, P < 0.001) and had concerning clinical factors, including lower glomerular filtration rate, more comorbidities such as diabetes, stroke, and a history of admission. Frail to pre-frail older hypertensive patients used slightly more antihypertensive medications than robust older hypertensive patients (1.95 vs. 2.06, P = 0.003). Pre-frail to frail patients often chose beta-blockers as a third medication over diuretics. Conclusion: This study described the general clinical characteristics of older hypertensive patients in Korea. Frail hypertensive patients face challenges in achieving positive clinical outcomes because of multifactorial causes: they are older, have more morbidities, decreased function, lower quality of life and cognitive function, and take more antihypertensive medications. Therefore, it is essential to comprehensively evaluate and monitor diseaserelated or drug-related adverse events more frequently during regular check-ups, which is necessary for pre-frail to frail older patients with hypertension.
#Frailty #Hypertension #Older #Elderly

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