Arterial hypertension as a risk factor for pre-disease and disease in the domain approach in elderly patients

Objective. To study the relationship between arterial hypertension (AH) and age-associated conditions within the domain approach. Material and methods. 100 female patients with AH at the age of 70 years were examined. The studied parameters included the characteristics of somatic health (anthropometry, blood pressure [BP], pulse, general blood analysis, ratio of neutrophils to lymphocytes, platelets to lymphocytes, blood biochemical parameters, glomerular filtration rate, echocardiography, electrocardiography, drug therapy), parameters of the musculoskeletal system (FRAIL, Katz scales, SARC-F questionnaire, hand compression force, bioimpedanceometry), indicators of the sensory (ophthalmologic examination), cognitive (MMSE test), psychological (Beck scale, asthenic state scale [ASAS]), nutritional (MNA scale) systems. Results. Patients with AH (systolic BP – 175 mm Hg, diastolic BP – 94 mm Hg), excessive body weight (body mass index – 37.1 kg/m2) and abdominal obesity (waist-to-hip ratio – 0.91) were revealed, elevated inflammatory markers (C-reactive protein – 4.5 mmol/L), reduced functional capacity (FRAIL – 2.0 points, SARC-F – 4.0 points), relatively preserved cognitive abilities (MMSE – 27.0 points, ASAS – 75.0 points) and vitamin D deficiency (25.50 mmol/L). The analysis showed that hypodynamia (p < 0.001), smoking (p = 0.014) and obesity (p < 0.001) were statistically significant predictors of elevated systolic BP. Moreover, elevated systolic BP was a predictor of chronic heart failure (p < 0.001), presarcopenia (p < 0.001), diabetes mellitus (p < 0.001) and age-related forgetfulness (p < 0.001). Conclusion. The obtained data indicate the presence of pre-disease and disease states of cardiovascular nosology, metabolic disorders and reduced functional capacity in the examined patients. Further studies are needed for more detailed analysis of the revealed features and development of individualized prevention and treatment strategies