• Anna Kańtoch, Agnieszka Pac, Barbara Wizner, Jadwiga Wójkowska-Mach, Piotr Heczko, Tomasz Grodzicki, and Barbara Gryglewska.
• Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Faculty of Medicine, University Hospital in Kraków, Kraków, Poland
• Pol. Arch. Med. Wewn. 2021 May 25; 131 (5): 439-446.

IntroductionLong-term care facility (LTCF) residents are typically excluded from clinical trials due to multimorbidity, dementia, and frailty, so there are no clear evidence-based rules for treating arterial hypertension in this population. Moreover, the role of hypertension as mortality risk factor in LTCFs has not yet been clearly established.ObjectivesThe study aimed to investigate whether treated hypertension is associated with lower mortality among older LTCF residents with multimorbidity.Patients And MethodsThe study was performed in a group of 168 residents aged ≥ 65 years in three LTCFs. Initial assessment included blood pressure (BP) measurements and selected geriatric scales: MNA-SF, AMTS and ADL. Hypertension, comorbidities, pharmacotherapy, antihypertensive drugs and mortality during one-year follow-up were extracted from the medical records. The data was compared in groups: Survivors and Deceased.ResultsSurvivors and Deceased revealed similar age, DBP, number of diseases, medications, and antihypertensive drugs. However, Deceased had significantly lower SBP (P <0.05) and presented significantly worse functional, nutritional and cognitive status than Survivors (P <0.001). Hypertension (P <0.001) and antihypertensive therapy (P <0.05) were significantly more frequent among Survivors. Significantly more of the hypertensive-treated than other multimorbid residents survived the follow-up (P <0.001). Logistic regression analysis showed that treated hypertension had a protective effect on mortality [OR = 0.11 (95% CI, 0.03-0.39); P <0.001].ConclusionsOne-year survival of LTCF residents with treated hypertension was significantly higher than the others. Appropriate antihypertensive therapy may be a protective factor against death in frail nursing home residents, even in short period of time.

10 keywords...

hide…