Objective To investigate the prevalence of target organ damage and analyze etiology in elderly hospitalized patients with hypertension.Methods A total of 1270 elderly inpatients aged 60 to 91 years from 2008 to 2012 were enrolled.This retrospective study was performed to analyze the etiology and the prevalence of target organ damage in hospitalized hypertensive patients.Results Among elderly hypertensive patients,secondary hypertension accounted for 14.2 ％ (180/1 270) while essential hypertension accounted for 85.8％ (1 090/1 270).In secondary hypertension,renovascular hypertension of atherosclerosis (67.8％) and primary aldosteronism (23.3％) had the higher prevalence rate.Among 1 090 hospitalized patients with essential hypertension,the prevalence of patients with ≥ 1 complications was 88.3 ％.The prevalence of cerebrovascular disease,coronary heart disease and chronic renal failure were 30.2 ％,26.7 ％ and 10.5 ％,respectively.The occurrence rate of the increased carotid intima-media thickness and left type hypertrophy were 66.6 ％ and 24.0 ％,respectively.The prevalence rate of cerebrovascular disease,coronary artery disease and chronic renal failure were increased with aging (P＜0.05).Compared with female,male patients had a higher prevalence rate of chronic renal failure (P＜0.05).Conclusions Secondary hypertension is mainly renovascular hypertension and primary aldosteronism in elderly patients with hypertension.And damage of target organ in elderly patients with primary hypertension is more common,highest with cerebral apoplexy among three target organs such as heart,brain and kidney disease.

Objective To evaluate the patient's health care demands in communication,diagnosis,treatment and medical counseling of geriatric BPH outpatients in China.Methods A survey study was carried out in 33 medical centers from 11 different cities in China (North:Lanzhou,Beijing,Shenyang; South:Chengdu,Changsha,Wuhan,Jinan,Nanjing,Hangzhou,Shanghai,Guangzhou).2027 BPH outpatients aged (60 years participated in the survey to measure their health care demands using a questionnaire.Results There were 955 cases (47.1％) thinking communication is necessary before inspection items by a doctor,807 (39.8 ％)thinking communication is necessary before determining the treatment program,389 cases(19.2％) thinking respection items by a doctor is necessary,730 cases(36.0％)the treatment program by a doctor is necessary,849 cases (41.9 ％)thinking health guidance on BPH dignosis is necessary,934 cases (46.1 ％)thinking health guidance on BPH treatment is necessary,The multilevel model showed the demands scores data is similarity among the north and the south.And the patients with more severe lower urinary tract symptoms have more demands on communication and medical counseling.Conclusions It is to get better therapy,considering the patient's health care demands.

Objective To explore the relationship between brachial ankle pulse wave velocity (BaPWV) change and carotid artery plaque formation in middle-aged and elderly patients with essential hypertension(EH).Methods A cross sectional study was conducted in 409 patients who were admitted in Hypertension Department in our hospital from January to September 2013.Their age ranged from 35 to 75 years,with mean aged(53.2±15.0) years.Parallel carotid artery ultrasound and BaPWV examination were performed in all patients.According to whether carotid plaques were present,patients were divided into two groups:carotid plaque group and control group.And carotid plaque group was sub-grouped into normal BaPWV group (BaPWV ＜ 1400cm/s) and increased BaPWV group(BaPWV≥1400 cm/s) according to BaPWV levels.The detection rate of carotid plaque was compared between normal BaPWV group and increased BaPWV group.The correlation between BaPWV and carotid plaques was analyzed by multivariate logistic regression analysis.Results Compared with the control group,carotid plaque group showed the prevalence of carotid plaques was increased along with the increases of age(t=11.0,P=11.0),systolic blood pressure (t=3.87,P=3.87),diastolic blood pressure(t=3.70,P=0.00),pulse pressure(t=6.13,P 6.13),total cholesterol levels(t=2.57,P=0.01).The detection rate of carotid plaque was higher in increased BaPWV group than in normal BaPWV group [62.6％(159/254) vs.43.2％(67/155),x2=14.61,P=0.00].After adjusting for age,blood pressure and other cardiovascular risk factors,the multivariate logistic regression analysis showed that increased BaPWV was an independent risk factor for carotid plaques(OR=2.06,P=0.05),and age,smoking,systolic pressure,diastolic pressure,pulse pressure,total cholesterol,low-density lipoprotein cholesterol,triglyceride levels were positively correlated with carotid plaques.Conclusions BaPWV is one of the independent impact factors for carotid plaques,which plays an important role in early diagnosis and screening for subclinical vascular lesions.

To analyze the relationship among ambulatory blood pressure (AMBP), ankle brachial index (ABI) and left ventricular mass index (LVMI) in hypertensive patients. Methods 578 hypertensive inpatients were reviewed. Results The general clinical dataof selected patients, their ABI, LVMI were not different significantly between male and female. The correlation analysis showed that LVMI was positively correlated with the 24-hour average systolic (r=0.245, P=0.000) or diastolic (r=0.158, P=0.000) blood pressure, whereas negatively correlated with percent of systolic (r=－0.104, P=0.012) or diastolic (r=－0.132, P=0.001) blood pressure declining at night. No significant correlation was found between LVMI and BMI. Multiple regression analysis revealed that LVMI was significant independently positive correlated with 24-hour average systolic blood pressure (P=0.000). Conclusion LVMI does not correlate with ABI, but independent positive related with 24-hour average systolic blood pressure.

Objective To study the present situation of benign prostatic hyperplasia (BPH) of male patients in geriatrics department. Methods Two thousand one hundred and twenty-five patients aged 60 years and above with BPH in geriatrics department of Chengdu, Lanzhou, Hangzhou, Wuhan, Changsha, Guangzhou, Shenyang, Shanghai, Nanjing, Jinan and Beijing were investigated using stratified cluster random sampling method. Results The constituent ratio of patients with benign prostatic hyperplasia in geriatrics department was 47.0%, and the proportions of the elderly of 60～,70～ ,80～ years old among the patients with benign prostatic hyperplasia were 18.1%,49.4 and 32.5%, respectively (x2 = 83.68, P<0.001). There was a significant difference in the occupation distribution of BPH constituent ratio: 66.4% for staffs of state organs, 18.0% for professional technical personnel and 14.7% for works and peasants (x2=410.27,P<0.001). The international prostate symptom scores (IPSS) were different among different cities (x2=101.00, P<0. 001 ). Logistic regression analysis showed that the IPSS was correlated with age and profession (age: OR= 1.029;worker and peasant as control group, working staff of state organs OR=O.707, professional technical personnel OR=0.339 ). Conclusions The benign prostatic hyperplasia is a common disease in male elderly patients in China, but the consultation rate is low. The IPSS of benign prostatic hyperplasia is correlated with age and profession. Prevention and treatment of benign prostatic hyperplasia in the elderly should be strengthened.

Objective To realize and analyze the current status of medical treatment for benign prostatic hyperplasia in special clinic for elderly in China.Methods The informations were gathered from 34 clinics for elderly located in 11 Chinese cities from February 2008 to September 2008.First, all male patients who visited the clinic were inquired about their history of benign prostatic hyperplasia , and then 1000 benign prostatic hyperplasia patients who were receiving medical treatment were selected to finish a detailed questionnaire and to get several examinations for benign prostatic hyperplasia.Results Among the 1000 patients, 774 completely finished the questionnaire, patients with middle or severe international prostate symptom score (IPSS) and with high volume of prostate occupied a large proportion.Medical treatments included the combined therapy of α-blockers plus 5α reductase inhibitors (45.48 %), α-blockers (36.30%), 5α reductase inhibitors (13.05 %) and other medicines (including phytotherapeutic agents and traditional medicines, 5.17%).Conclusions Nowadays in China, as to the prescription for benign prostatic hyperplasia in the clinic for elderly presents, doctors only concentrate on the improvement of symptoms, whereas ignore the progression of the disease.There is still a considerable gap between real medical treatment and international guidelines.Therefore, improvements of medical treatment are still needed in the future clinical practice.

ObjectiveTo understand the prevalence of urinary incontinence (UI) and its epidemiological characteristics in rural elderly people and to lay a scientific foundation for formulating the strategies oI prevention and treatment for UI. MethodsA cross-sectional study was carried out in two townships of Jixian County, Tianjin. People aged 60 years and over were selected with cluster sampling, and the prevalence of UI and its epidemiological characteristics were collected with a standardized structured questionnaire by face-to-face interview. ResultsPrevalence of UI was 33.4% among the people aged 60 years and over in two townships, and it was increased with ageing.The elderly women had a higher prevalence of UI than the elderly man (43.2% vs. 22.8%, P<0.0001). The prevalences of UI in groups of 60-, 65-, 70-, 75-, 80-, 85-95 years old were 28.6%,32.1%,34.1%,35.5%,47.8%and 30.0%, respectively, and increased with ageing (X2for trend=2.19,P=0.029). Mixed UI (MUI) was the most common in different types of UI, and the constitution ratios of stress UI (SUI), urge UI (UUI), MUI and other type of UI were 27.4%, 1.2%, 60.9%,10.5%, respectively. The prevalence of MUI was the highest among the four types of UI in each age group. In all age groups, the prevalences of SUI and UUI were the highest in 60～ age group, and the prevalence of MUI was the highest in 80 ～ 95 age group. ConclusionsPrevalence of UI is high among the elderly people in rural areas of Jixian County, Tianjin.

Objective To evaluate the diagnostic and therapeutic status of lower urinary tract symptoms(LUTS)/benign prostatic hyperplasia (BPH) (LUTS/BPH) in outpatient department for elderly patients, and to understand the patients' attitude and knowledge on the disease. Methods The investigation was conducted in 34 outpatient departments for elderly patients located in 11 cities from February to September 2008. The male patients who came to the clinic during the survey time were investigated whether they had LUTS /BPH history or not. Then some eligible patients were chosen to accept a more detailed questionnaire and BPH-related examinations. Results There were 31371 male patients who came to the clinic. 47.0% of them (14748 cases) had the history of LUTS / BPH, and 72.4 % (10678 cases) had medical or surgical treatments presently or previously, whereas 27.6% were untreated. The three most commonly performed examinations in clinical practice were urinalysis, prostate specific antigen (PSA) and transabdominal ultrasonography. In 3542 patients receiving medical investigation, 32.6% (1155 cases) were given 5a reductase inhibitor, and 35.0% (1239 cases) received a combination therapy of 5a reductase inhibitor plus a receptor blocker. 84.5 (1796 cases) and 79.0% (1678 cases) of all the patients were satisfied with the examinations and treatments respectively. Conclusions LUTS and BPH are common in outpatient department for elderly patients. There are discrepancies of examinations and medical treatments between real medical practice and international suggestion, and the patients' understanding of the disease should be improved

PURPOSE: To assess the compliance of Chinese urologists with China's benign prostatic hyperplasia (BPH) clinical practice guideline and to explore the diagnosis and therapy modalities for geriatric patients with BPH. METHODS: A cross-sectional survey study was carried out in 33 medical centers in 11 different cities in China. A total of 190 urologists participated in a survey to record their preferences for diagnostic tests and treatment options for BPH outpatients. Diagnostic test results as well as health care demands were collected by surveying 2,027 outpatients aged 60 years and older. RESULTS: The survey response rate was 97.4%. The respondents generally used the diagnostic tests recommended in China's BPH clinical practice guideline at varying rates. The used rates for medical history, ultrasonography, and urinalysis were above 90.0%; that for uroflowmetry was 31.2%. In addition, the rate of use of recommended tests was higher among doctors in the north than among those in the south. Combination therapy with alpha-adrenoceptor antagonists and 5alpha-reductase inhibitors was the preferred treatment option for BPH, and was increasingly used with worsening lower urinary tract symptoms. Finasteride was the most prescribed medication (48.0%), followed by tamsulosin (22.7%). CONCLUSIONS: This study assessed the preferences of urologists in the diagnosis and treatment of BPH, which will serve as an important reference for updating and improving China's current BPH clinical practice guideline.
Aged ; Asian Continental Ancestry Group ; China ; Compliance ; Cross-Sectional Studies ; Delivery of Health Care ; Diagnostic Tests, Routine ; Finasteride ; Humans ; Lower Urinary Tract Symptoms ; Methods* ; Outpatients ; Practice Guidelines as Topic ; Prostatic Hyperplasia ; Sulfonamides ; Surveys and Questionnaires ; Urinalysis

Objective To evaluate the demands of patients with benign prostatic hyperplasia (BPH) and its influencing factors. Methods One thousand five hundred and twenty-seven patients (≥60 years old) with BPH in 26 hospitals of 9 cities were selected in the study by using stratified random sampling method. The demands of patients with BPH and its influencing factors were evaluated by rank sum test and rank correlation analysis. Results In 1527 BPH patients, most patients thought that doctors' communication with them before opening examination items (1297/ 1527,84.9%),health guidance for BPH progress(1310/1527,85.8%), BPH diagnosis(1279/1527, 83.8 %) and BPH treatment(1329/1527,87. 0%) were necessary. Doctors'communication with them before opening examination items, health guidance for BPH progress, BPH diagnosis and BPH treatment showed significant statistical difference among patients with different age, medical care, the lasting time of clinical symptoms, diagnosis time, international prostate symptom scores and quality of life scores (all P<0. 05). While in patients with different nation, retirement status, marital status, living style and average family income, there were no significant statistical difference in needing the doctors'communication with them before opening examination items, health guidance for BPH progress, BPH diagnosis and BPH treatment(all P>0.05). Conclusions Patients with BPH have a higher demand for treatment. The demand degree is related with age group, health care, the lasting time of clinical symptoms, diagnosis time, international prostate symptom scores and quality of life scores. Most patients have desire to accept health guidance.