社区老年高血压患者并发衰弱现状及影响因素的Meta分析

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (2195 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的：通过Meta分析探讨社区老年高血压患者并发衰弱的发生率及危险因素。方法：计算机检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、Web of Science、Embase、Cochrane Library数据库,检索从建库至2023年2月有关社区老年高血压患者并发衰弱影响因素的原始文献并追溯其参考文献,由2名评价人员按照标准独立筛选文献、提取资料、评价文献质量。使用Stata 12.0和RevMan 5.4进行数据分析。结果：共纳入15篇文献,包括27个危险因素,Meta分析结果显示社区老年高血压患者衰弱发生率为22.5% （95%CI: 16%~29%）,其中高龄（OR=1.54,95%CI：1.34~1.76）、女性（OR=1.33,95%CI：1.21~1.45）、高血压病程超过10年（OR=25.81,95%CI：2.03~327.62）、高BMI（OR=2.00,95%CI：1.28~3.12）、低文化程度（OR=3.50,95%CI：2.26~5.43）、缺乏运动锻炼（OR=1.50,95%CI：1.96~5.18）、抑郁（OR=1.13,95%CI：3.83~17.37）、糖尿病（OR=1.74,95%CI：1.29~2.55）、听力障碍（OR=1.33,95%CI：2.43~4.96）等9个因素为社区老年高血压患者并发衰弱的危险因素。结论：社区老年高血压患者衰弱发生率较高,且影响因素较多。应开展针对性、个体化的干预措施,以降低患者衰弱的发生率,提高患者生活质量。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	李群
	段安艳
	蒋洁琼
	李玲
	胡蛟
	陈炜

关键词 ：社区, 老年人, 高血压, 衰弱, 危险因素, Meta分析

Abstract：Objective To systematically review the prevalence and risk factors for frailty in elderly patients with hypertension. Methods We searched the CNKI, VIP, WanFang Data, SinoMed, PubMed, Web of Science, Embase, and Cochrane database from the inception to February 2023 for the eligible original studies. Studies reporting on the prevalence and risk factors for frailty in elderly hypertensive patients were included. Two reviewers independently screened literature, appraised the study methodological quality, extracted data, then performed meta-analysis using Stata12.0 and RevMan5.4. Results A total of 15 studies including 27 risk factors met the inclusion criteria. The pooled prevalence of frailty in hypertensive patients was 22.5% (95%CI: 16%, 29%). The main risk factors for frailty were age (OR=1.54, 95%CI: 1.34~1.76), females (OR=1.33, 95%CI: 1.21~1.45), hypertension course (OR=25.81, 95%CI: 2.03~327.62), BMI (OR=2.00, 95%CI: 1.28~ 3.12), education level (OR=3.50, 95%CI: 2.26, 5.43), lack of physical activity (OR=1.50, 95%CI: 1.96~ 5.18), depression (OR=1.13, 95%CI: 3.83~17.37), diabetes (OR=1.74, 95%CI: 1.29~2.55), and hearing impairment (OR=1.33, 95%CI: 2.43~4.96) were risk factors for frailty in elderly hypertensive patients. Conclusion Frailty is highly prevalent among hypertensive patients and is affected by many factors. Targeted and individualized interventions should be taken to reduce the incidence of frailty and improve the quality of life of patients.

Key words： community aged hypertension frailty risk factors Meta-analysis

收稿日期: 2023-10-15

中图分类号:

R544.1

基金资助:湖南师范大学医学院2023年度开放基金项目“中青年高血压患者运动行为改变的现状及影响因素：一项混合性研究”（KF2022040）

通讯作者: 陈炜,E-mail：Cweixy3@126.com

引用本文:

李群, 段安艳, 蒋洁琼, 李玲, 胡蛟, 陈炜. 社区老年高血压患者并发衰弱现状及影响因素的Meta分析[J]. 湖南师范大学学报(医学版), 2023, 20(6): 151-156. LI Qun, DUAN Anyan, JIANG Jieqiong, LI Ling, HU Jiao, CHEN Wei. Prevalence and risk factors of frailty in elderly hypertensive patients in the community: a Meta-analysis. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(6): 151-156.

链接本文:

http://yxb.hunnu.edu.cn/CN/ 或 http://yxb.hunnu.edu.cn/CN/Y2023/V20/I6/151

[1] 李苏宁, 陈祚, 王增武, 等. 我国老年人高血压现状分析[J]. 中华高血压杂志, 2019, 27(02): 140-148.
[2] 刘雅萌, 阳晓丽, 张彩虹. 老年高血压相关性衰弱的发病机制及运动干预机制的研究进展[J], 2023, 26(05): 635-640.
[3] SUGIMOTO K, YAMAMOTO K.Hypertension, the decline of activities of daily living (ADL) and frailty[J]. Hypertens Res, 2022, 45(4): 629-634.
[4] POBROTYN P, PASIECZNA A, DIAKOWSKA D, et al.Evaluation of Frailty Syndrome and Adherence to Recommendations in Elderly Patients with Hypertension[J]. J Clin Med, 2021, 10(17): 3771.
[5] MA L, ZHANG L, SUN F, et al.Frailty in Chinese older adults with hypertension: Prevalence, associated factors, and prediction for long-term mortality[J]. J Clin Hypertens (Greenwich), 2018, 20(11): 1595-1602.
[6] 中国老年医学学会高血压分会, 北京高血压防治协会, 国家老年疾病临床医学研究中心 (中国人民解放军总医院, 首都医科大学宣武医院). 中国老年高血压管理指南2023[J]. 中华高血压杂志, 2023, 31(06): 508-538.
[7] YOSHIYUKI N, ISHIHARA T, KONO A, et al.Do Home- and Community-Based Services Delay Frailty Onset in Older Adults With Low Care Needs?[J]. J Am Med Dir Assoc, 2023, 24(11): 1663-1668.
[8] LEFFERTS E C, BAKKER E A, CARBONE S, et al.Associations of total and aerobic steps with the prevalence and incidence of frailty in older adults with hypertension[J]. Prog Cardiovasc Dis, 2021, 67: 18-25.
[9] KANG M G, KIM S A-O, YOON S J, et al. Association between Frailty and Hypertension Prevalence, Treatment, and Control in the Elderly Korean Population[J]. Sci Rep, 2017, 7(1): 7542.
[10] 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具[J]. 中国循证心血管医学杂志, 2012, 4(04): 297-299.
[11] WANG C, ZHANG J C, HU C P, et al.Prevalence and Risk Factors for Cognitive Frailty in Aging Hypertensive Patients in China[J]. Brain Sciences, 2021, 11(8): 1018.
[12] MA L, ZHANG L, SUN F, et al.Frailty in Chinese older adults with hypertension: Prevalence, associated factors, and prediction for long-term mortality[J]. J Clin Hypertens, 2018, 20(11): 1595-1602.
[13] MA L, CHHETRI J K, LIU P, et al.Epidemiological characteristics and related factors of frailty in older Chinese adults with hypertension: a population-based study[J]. J Hyperten, 2020, 38(11): 2192-2197.
[14] KOIZUMI Y, HAMAZAKI Y, OKURO M, et al.Association between hypertension status and the screening test for frailty in elderly community-dwelling Japanese[J]. Hypertens Res, 2013, 36(7): 639-644.
[15] 宋晓月. 居家运动对伴有衰弱的高血压患者干预效果研究[D]. 郑州: 郑州大学, 2018.
[16] 金蓉. 农村老年高血压患者居家安全风险与衰弱指数的关系[D]. 唐山: 华北理工大学, 2018.
[17] 谭修竹, 冯静, 王志敏, 等. 社区高血压患者衰弱现状及其影响因素[J]. 医学信息, 2022, 35(03): 139-142.
[18] 王玺博. 社区老年高血压患者衰弱的发生情况及其与体质指数的相关性[J]. 广西医学, 2019, 41(17): 2249-2250+2261.
[19] 黄小洁, 庞玲玲, 黄鳞茜, 等. 社区老年高血压患者衰弱现状及影响因素研究[J]. 当代护士 (下旬刊), 2021, 28(10): 13-17.
[20] 胡俊芳. 社区老年高血压人群衰弱的影响因素和自我管理的作用[D]. 上海: 上海交通大学, 2020.
[21] 王水玲. 社区老年中重度高血压患者衰弱与生活质量的关系及衰弱轨迹研究[D]. 南宁: 广西中医药大学, 2022.
[22] 李建华. 衰弱对老年高血压预后的影响及运动干预基础研究[D]. 北京: 解放军总医院, 2017.
[23] 李惊鸿. 社区老年高血压合并衰弱前期患者的自我管理方案构建研究[D]. 重庆: 重庆医科大学, 2020.
[24] 李志强, 王盛书, 贡鑫然, 等. 北京市农村社区老年高血压患者认知衰弱状况及影响因素分析[J]. 中国慢性病预防与控制, 2022, 30(12): 915-919.
[25] LIN H, WANG D, MA S, et al.Frailty's Prevalence and the Association with Aging-Related Health Conditions in Chinese Community Dwelling Elderly[J]. Comput Intell Neurosci, 2022, 2022: 1748162.
[26] WALSH B, FOGG C, HARRIS S, et al. Frailty transitions and prevalence in an ageing population: longitudinal analysis of primary care data from an open cohort of adults aged 50 and over in England, 2006-2017[J]. Age Ageing, 2023, 52(5): afad058.
[27] 罗健钊, 郭茹, 苏艳玲, 等. 衰弱与高血压的最新临床研究进展[J]. 中国全科医学, 2021, 24(32): 4145-4149+4159.
[28] 陈雨朦, 刘青青, 钱媛. 衰弱评估工具在不同老年人群中的应用现状[J]. 护理学杂志, 2022, 37(24): 89-94.
[29] LEE H, LEE E, JANG I Y.Frailty and Comprehensive Geriatric Assessment[J]. J Korean Med Sci, 2020, 35(3): e16.
[30] ZAMORA-SÁNCHEZ J J, URPÍ-FERNÁNDEZ A M, SASTRE-RUS M, et al. The Tilburg Frailty Indicator: A psychometric systematic review[J]. Ageing Res Rev, 2022, 76: 101588.
[31] HU K, ZHOU Q, JIANG Y, et al.Association between Frailty and Mortality, Falls, and Hospitalization among Patients with Hypertension: A Systematic Review and Meta-Analysis[J]. Biomed Res Int, 2021, 2690296.
[32] HOOGENDIJK E O, AFILALO J, ENSRUD K E, et al.Frailty: implications for clinical practice and public health[J]. Lancet, 2019, 394(10206): 1365-1375.
[33] GALE C R, COOPER C, SAYER A A.Prevalence of frailty and disability: findings from the English Longitudinal Study of Ageing[J]. Age Ageing, 2015, 44(1): 162-165.
[34] IRSHAD C, GOVIL D, SAHOO H.Social frailty among older adults in India: Findings from the Longitudinal Ageing Study in India (LASI) - Wave 1[J]. Exp Aging Res, 2023, 28: 1-17.
[35] NAVANEETHAN P R, KEKRE A, JACOB K S, et al.Vitamin D deficiency in postmenopausal women with pelvic floor disorders[J]. J Midlife Health, 2015, 6(2): 66-69.
[36] 程青霞, 张丽萍, 郭蕾. 老年高血压患者衰弱患病率的meta分析[J]. 现代医药卫生, 2023, 39(08): 1336-1343.
[37] 王水玲, 杨连招, 陈玲等. 社区老年中重度高血压患者衰弱发展轨迹及影响因素研究[J]. 中华护理教育, 2023, 20(03): 343-349.
[38] AVVARI A, REDDY B M, GANGULY E, et al.Assessment of frailty syndrome with coexisting hypertension and depression among older individuals, aged >80 years of age[J]. J Frailty Sarcopenia Falls, 2022, 7(2): 72-80.
[39] 陈楚媛, 沈勤. 医养结合机构非卧床老年人衰弱现状及影响因素分析[J]. 护理学杂志, 2022, 37(20): 90-93.
[40] UEMURA K, TSUKASA K, WATANABE A, et al.Association between community-level health literacy and frailty in community-dwelling older adults[J]. Aging Clin Exp Res, 2023, 35(6): 1253-1261.
[41] SOBHANI A, SHARIFI F, FADAYEVATAN R, et al.Low physical activity is the strongest factor associated with frailty phenotype and frailty index: data from baseline phase of Birjand Longitudinal Aging Study (BLAS)[J]. BMC Geriatr, 2022, 22(1): 498.
[42] ANGULO J, EL ASSAR M, ÁLVAREZ-BUSTOS A, et al.Physical activity and exercise: Strategies to manage frailty[J]. Redox Biol, 2020, 35: 101513.
[43] KIM N, KIM G S, WON C W, et al.Two-year longitudinal associations between nutritional status and frailty in community-dwelling older adults: Korean Frailty and Aging Cohort Study[J]. BMC Geriatr, 2023, 23(1): 216.
[44] NETZ Y, BEN-ZAKEN S, ZEEV A, et al.Correlates of Early-Stage Frailty-Sleep, Fitness, Oxidative Stress, and BMI[J]. Front Med (Lausanne), 2020, 7: 594710.
[45] YUAN L, CHANG M, WANG J.Abdominal obesity, body mass index and the risk of frailty in community-dwelling older adults: a systematic review and meta-analysis[J]. Age Ageing, 2021, 50(4): 1118-1128.
[46] DELLI ZOTTI G B, CITTERIO L, FARINONE S, et al. Association between Perceived Health-Related Quality of Life and Depression with Frailty in the FRASNET Study[J]. Int J Environ Res Public Health, 2022, 19(24).
[47] WANG Y, LI R, YUAN L, et al.Association between diabetes complicated with comorbidities and frailty in older adults: A cross-sectional study[J]. J Clin Nurs, 2023, 32(5-6): 894-900.
[48] KARAKOUSIS N D, BILIOU S, PYRGIOTI E E, et al.Frailty, sarcopenia and diabetic kidney disease: where do we stand?[J]. Int Urol Nephrol, 2023, 55(5): 1173-1181.
[49] 白惠琼, 韦萍萍, 郭晋荣, 等. 社区老年膝关节骨性关节炎病人社会衰弱现状及影响因素[J]. 循证护理, 2023, 9(06): 1095-1100.
[50] 何玉, 刘谦, 秦明照. 视力听力障碍对老年人的影响[J]. 中国临床保健杂志, 2023, 26(01): 131-134.
[51] LIU Y, MENG H, TU N, et al.The Relationship Between Health Literacy, Social Support, Depression, and Frailty Among Community-Dwelling Older Patients With Hypertension and Diabetes in China[J]. Front Public Health, 2020, 8: 280.
[52] SOYSAL P, ARIK F, SMITH L, et al.Inflammation, Frailty and Cardiovascular Disease[J]. Adv Exp Med Biol, 2020, 1216: 55-64.
[53] ZENG X Z, JIA N, MENG L B, et al.A study on the prevalence and related factors of frailty and pre-frailty in the older population with hypertension in China: A national cross-sectional study[J]. Front Cardiovasc Med, 2023, 9: 1057361.
[54] ZHANG X, LIU Y, VAN DER SCHANS C P, et al. Frailty among older people in a community setting in China[J]. Geriatr Nurs, 2020, 41(3): 320-324.