ObjectiveTo investigate the relationship between angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and diabetic essential hypertension in elderly population.MethodsPolymerase chain reaction (PCR) technique was used in 260 elderly normal control patients, 205 elderly hypertensive patients and 138 elderly diabetic hypertensive patients to detect the I/D polymorphism in ACE gene.ResultsDD genotype frequency (0.352) and D allele frequency (0.543) in elderly hypertensive patients were higher than those in the normal control patients. DD genotype (0.421) and D allele frequency (0.579) in elderly diabetic hypertensive patients were significantly higher than those in the control patients (0.133 and 0.250). The differences of DD genotype and D allele frequency between the elderly hypertensive patients and the elderly diabetic hypertensive patients were not significant (P > 0.05).ConclusionACE gene deletion is a risk factor for hypertension but is not a risk factor for diabetes in elderly population.
Objective To observe the infl uence of two hydration regimens on the renal function of elderly patients undergoing percutaneous coronary intervention (PCI). Methods Forty fi ve elderly patients with coronary artery disease (CAD) scheduled for PCI were randomly assigned to receive isotonic (0.9% saline) (observe group) or half-isotonic (0.9% sodium chloride plus 5% glucose) hydration (compare group). Hydration liquid were administered at 1.5 ml/kg·h for 6 h after PCI. The serum creatinine (SCr) were detected before and 1, 3, 7 days after PCI. Results Baseline characteristics such as age, gender, baseline SCr, estimated glomerular fi ltration rate (eGFR), left ventricular ejection fraction (LVEF) were well matched. The incidence of diabetes in observe group is higher than compare group (10/24 vs 2/21, x 2 =5.917, p<0.05). The other risk factors for CIN such as >75 years, hypertension, chronic heart failure (CHF), chronic renal failure (CRF) have no signifi cant difference between two groups. The contrast media dosage and SCr levels after PCI were not signifi cantly different between groups. Hydration fl uid volume used in observe group is lower than compare group (968.8±258.7 ml vs 1214.3±381.5 ml, p<0.05). The volume of 0.9% saline used for hydration is positively related to the eGFR measured 7 days after PCI. An increase in SCr >25% from baseline was observed in seven patients 3 days after PCI. Average increase was 33.1±4.5% or 26.9±6.6 μmol/l (22-41 μmol/l). The patients with CIN are older and has lower baseline LVEF than that non-CIN. SCr levels of six prediagnosed CRF patients were not signifi cantly different before and after PCI. No deterioration of heart function or acute left heart failure were observed in seven CHF patients. Conclusion CAD patients with advanced age and deceased heart function is more vulnerable to CIN. Hydration regimen can effectively protect renal function and is well tolerated in elderly CHF patients. 0.9% saline isotonic hydration is superior to half-isotonic hydration in the prevention of CIN.
Objectives To investigate the prevalence of sleep apnea hypopnea syndrome (SAHS) in elderly patients with cardiovascular disease. Methods The sleep monitoring using micro-sensitive mattress sleep monitoring system was performed in 127 hospitalised patients aged 60 or over at least two nights for detecting SAHS. The patients had one or more cardiovascular diseases, such as coronary heart disease, hypertension, arrhythmias, heart failure, or/and diabetes and impaired fasting glucose and (or) glucose tolerance abnormalities, hyperuricemia and chronic kidney disease. Results There are 101 males and 26 females into this study. The average age of patients was 76.4 ± 6.8 years. 107 SAHS cases were detected. The percentage of SAHS was 84.3%. The mean apnea hypopnea index (AHI) was 22.6 ± 14.7. 64 cases were moderate or severe SAHS since their AHI≥ 15. The main respiratory events was obstructive. However, with age increasing, the time of obstructive respiratory events were shorten and hypopnea events extended, r = -0.280, P <0.01, r = 0.194, P < 0.05, respectively. The number of cases with coronary heart disease in SAHS group were more than that in the control’s, P <0.05. Nocturnal hypoxemia were detected in all of 118 cases who received monitoring of oxygen saturation in whom 50 cases (41.7%) were severe. The average level of lowest oxygen (LO2) was (79.0 ± 7.2)% and mean oxygen (AO2) was (92.8 ± 2.7)%. The age of patients was significant positive correlated with HI and negative correlated with LO2, P <0.01. The negative correlation between age and LO2 was still present after adjusted the parameters of breathing disorder, r = -0.223, P <0.05. Conclusions The prevalence of SAHS and nocturnal hypoxemia was very high on elderly patients with cardiovascular diseases. The hypopnea events of SAHS aggravate nocturnal hypoxemia existed in elderly patients with ageing.
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