Blood pressure reduction in elderly: a randomised controlled trial of methyldopa.

A total of 123 out of 549 elderly residents of local authority welfare homes in Nottinghamshire were found at screening to have a standing or lying diastolic blood pressure of 100 mm Hg or more. These 123 subjects were randomly allocated to simple observation or to treatment with methyldopa. The cumulative mortality was similar in the observed and treated groups and in the normotensive group from which the subjects had been separated. Thus moderate hypertension, whether treated or not, was not a major risk predictor in the elderly population studied.     

Blood pressure in the Caribbean.

A review of original and published data yields the consistent finding that chronic hypertension is endemic and prevalent throughout the Caribbean area. The prominent involvement of genetics is suggested in several lines of evidence, including significant ethnic differences in blood pressure values, higher incidence in smaller isolated island populations, the discovery of polymorphic blood proteins that appear to be linked to hypertension susceptibility, and the slavery hypothesis of natural selection favoring a salt-conserving physiology in ancestral populations. Environmental factors--climatic, demographic, and cultural--exert strong influences on blood pressure levels and hypertension etiology in the Caribbean. Salt intake and other dietary behaviors, degree of community awareness of the disease, and differential treatment modalities are related to hypertension epidemiology in indigenous and migrant Caribbean populations. The traditional use of medicinal plants, historically successful in part because of the beneficial bioactivity of many antihypertensive phytochemical components, has been recently supplemented with the widespread introduction of synthetic biomedical drugs. Prospective research strategies are recommended that might further elucidate the complex gene-environment interactions contributing to blood pressure variation and hypertension patterns in the Caribbean region.     

Blood pressure follows the kidney

Epidemiological and experimental data strongly suggest that cardiovascular diseases can originate from an aberrant environment during fetal development, a phenomenon referred to as perinatal programming. This review will focus on the role of the kidneys in determining blood pressure, and how (re)programming the renal development can persistently ameliorate hereditary hypertension. By combining physiologic and genomic studies we have discovered some candidate pathways suited for (re)programming the development of hypertension. This sets the stage for mechanistic analysis in future studies.     

Blood pressure in night shift workers: circadian rhythms and levels, and their seasonal variation

Average diurnal blood pressure (BP) profiles (DBPP) were studied in persons working at different hours of a day, including night workers. The results obtained in winter and summer seasons were compared. The study consisted of more than 497 000 pre-work BP measurement points for each of 30 566 locomotive drivers. It was found that average DBPP of persons working at different hours of a day is of the marked non-dipper type in spite of night wakefulness. BP was lower at night but not as low as that of night sleeping persons. In the cohort studied, the form of DBPP curve does not differ in winter and summer; however BP in winter is significantly higher.     

Blood pressure lability in the sympathectomized rat

Intra-aortic blood pressure (BP) was measured in conscious rats after early chronic destruction of the peripheral sympathetic nervous system (SNS) with guanethidine. In sympathectomized rats, the mean level of BP was not different from that of control rats but its variability was markedly increased. These results indicate that functional integrity of the SNS is of primary importance for the short-term control of BP but is not essential for its long-term maintenance.     

Prevalence of oral mucosal lesions in institutionalized elderly people in Mashhad, Northeast Iran

doi: 10.1111/j.1741‐2358.2011.00588.x
Prevalence of oral mucosal lesions in institutionalized elderly people in Mashhad, Northeast Iran Objective: The aim of this study was to determine the prevalence of oral mucosal lesions in institutionalized elderly people in Mashhad, northeast of Iran. Background: This study was conducted to assess the prevalence of oral lesions in the institutionalized elderly. Methods: In this survey, we studied all of the nursing homes in Mashhad; a total of five encompassing 237 residents. The subjects were examined and lesions recorded in a designed checklist. T‐test, chi‐square and Fisher’s exact tests were used for the analysis. Results: The mean age of the patients was 79.59 ± 8.88. Ninety‐eight per cent of cases had at least one oral mucosal lesion. The most common lesions were fissured tongue (66.5%), atrophic glossitis (48.8%), sublingual varicosity (42%) and xerostomia (38%). There was no significant difference in the prevalence of denture‐related lesions (DRLs) between men and women (p > 0.05). Xerostomia was more prevalent in 70–79‐year‐old than in 60–69‐year‐old subjects. No case of oral malignant lesion was detected. Discussion: These findings revealed a higher prevalence of oral mucosal lesions in Mashhad city compared with other studies conducted in other major cities in Iran and abroad. The results emphasise the necessity of national programmes towards oral health promotion.     

Seasonal variation in arterial blood pressure.

Blood pressure measurements recorded during the medical Research Council''s treatment trial for mild hypertension have been analysed according to the calendar month in which the readings were made. For each age, sex, and treatment group systolic and diastolic pressures were higher in winter than in summer. The seasonal variation in blood pressure was greater in older than in younger subjects and was highly significantly related to maximum and minimum daily air temperature measurements but not to rainfall.     

Personal control of care provision and functional performance of non-institutionalized and institutionalized elderly

The present study is part of a broader investigation on the effects of living in a home for the elderly on functional performance and opportunities for successful aging. Functional performance is defined as the daily activities people actually execute in the domains of housekeeping, self-care, and leisure and social activity. In this first study, a comparison was made between community dwelling elderly and aged people living in an institution, in order to investigate the effect of living in an institution on functional performance (FP) in different domains and on personal control (PC) of the received care. The data were gathered in a structured interview, administered to 74 non-institutionalized and 79 institutionalized elderly, aged 71 to 97 years, living in Flanders. We found institutionalized elderly to be less active in every domain of functioning and experiencing less control of the received care. Significant negative correlations between age, FP and PC were only found in the sample of community-dwellers. It seems that in homes for the elderly, care is provided in a package about which the residents have minimal control, which leads to a homogenisation of daily functioning in the institution.