Atenolol use is associated with long-term mortality in community-dwelling older adults with hypertension

Aim The role of atenolol, a non‐vasodilating beta‐blocker drug, on long‐term mortality in hypertensive older adults is still unclear. The aim of the present study was to evaluate long‐term mortality in community‐dwelling hypertensive older adults taking atenolol. Methods Long‐term mortality after 12‐year follow up in isolated hypertensive older adults (n = 972) was analyzed. The patients were stratified in the presence and absence of atenolol use. Systolic, diastolic and pulse arterial pressure were measured. Results Older adults taking atenolol showed a greater mortality and higher pulse arterial pressure values than those not taking atenolol (73.9% vs 55.0%; P = 0.047 and 74.7 ± 14.1 vs 63.0 ± 14.2 mmHg, P < 0.001, respectively). Cox regression analysis showed that atenolol use (hazard risk 1.91; 95% confidence interval 1.04–4.31; P = 0.04) and pulse arterial pressure (hazard risk 1.02; 95% confidence interval 1.01–1.03; P = 0.032) were predictive of long‐term mortality. Conclusions Atenolol use was related to increased mortality in community‐dwelling hypertensive Older adults. This increase in mortality risk seems to be related to an increase of pulse arterial pressure. Geriatr Gerontol Int 2014; 14: 153–158

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Not AvailableThe socio-economic outputs for the Gopalagiri Colony-1 micro-watershed (Basavapur sub-watershed, Gundlupet taluk, Chamarajanagar district are presented here. Social Indicators); - Male and female ratio is 59.5 to 40.5 per cent to the total sample population. - Younger age groups 18 to 50 years group of population is around 54 per cent to the total population. - Literacy population is around 78.4 per cent. - Social groups belong to other backward caste (OBC) is around 77.8 per cent. - Liquefied petroleum gas (LPG) is the source of energy for a cooking among 88.9 per cent. - About 44.4 per cent of households have a yashaswini health card. - About 11.1 per cent farm households are having MGNREGA card for rural employment. - Dependence on ration cards for food grains through public distribution system is around 88.9 per cent. - Swach bharath program providing closed toilet facilities is among all the sample households. - Institutional participation is only 24.3 per cent of sample households. 2 - Rural migration to unban centre for employment is prevalent among 18.9 per cent of farm households. - Women participation in decisions making are around 66.8 per cent of households were found. Economic Indicators; - The average land holding is 0.66 ha indicates that majority of farm households are belong to marginal farmers. The dry land account for 65.1 % and irrigated land 34.9 % of total cultivated land area among the sample farmers. - Agriculture is the main occupation among 90.6 per cent and agriculture is the main and non-agriculture labour is subsidiary occupation for 28.1 per cent of sample households. - The average value of domestic assets is around Rs.8070 per household. Mobile and television are mass popular mass communication media. - The average farm assets a value is around Rs.11850 per household, about 44.4 per cent of sample farmers own plough. - The average livestock value is around Rs.26600 per livestock; about 100 per cent of household are having livestock. - The average per capita food consumption is around 641.6 grams (1561 kilo calories) against national institute of nutrition (NIN) recommendation at 827 gram. Around 77.8 per cent of sample households are consuming less than the NIN recommendation. - The annual average income is around Rs. 45088 per household. Among all farm sample households are below poverty line. - The per capita monthly average expenditure is around Rs.1242. Environmental Indicators-Ecosystem Services; - The value of ecosystem service helps to support investment to decision on soil and water conservation and in promoting sustainable land use. - The onsite cost of different soil nutrients lost due to soil erosion is around Rs.773 per ha/year. The total cost of annual soil nutrients is around Rs. 402711 per year for the total area of 550.02 ha. 3 - The average value of ecosystem service for food grain production is around Rs. 19780/ha/year. Per hectare food grain production services is maximum in banana (Rs. 96601), followed by turmeric (Rs. 45085), maize (Rs. 26807), red gram (Rs. 19672), horse gram (Rs. 6623), bajra (Rs. 4432), groundnut (Rs. 2961). - The average value of ecosystem service for fodder production is around Rs. 2806/ ha/year. Per hectare fodder production services is maximum in horse gram (Rs. 5472) followed by ragi (Rs. 3800), sorghum (Rs. 3529), maize (Rs. 2609), groundnut (Rs. 1051) and bajra (Rs. 374). - The data on water requirement for producing one quintal of grain is considered for estimating the total value of water required for crop production. The per hectare value of water used and value of water was maximum in banana (Rs. 185838) followed by turmeric (Rs. 54978), sorghum (Rs. 53775), bajra (Rs. 52269), red gram (Rs. 51718), sunflower (Rs. 39261), maize (Rs. 37562), groundnut (Rs. 23392), horse gram (Rs. 22578) and ragi (Rs. 15479). Economic Land Evaluation; - The major cropping pattern is bajra (29.8 %) followed by horse gram (12.8 %), groundnut (10.9 %), red gram (10.8 %), maize (10.4 %), sunflower (10.4 %), turmeric (6.2 %), banana (5.4%), safflower (2.3 %) and sorghum (0.9 %). - In Gopalgiri colony 1 micro-watershed, major soils are Annurkeri (ARK) soil series are having deep soil depth cover around 18.25 per cent of area. On this soil farmers are presently growing groundnut (46.8 %), turmeric (26.78 %) and bajra (26.5 %). Bheemanabeedu (BMB) soil series are having deep soil depth cover around 14.9 per cent of area; the major crops grown are sunflower (83.3 %) and sorghum (16.7 %), Devarahalli (DRH) having moderately shallow soil depth covers around 10.83 per cent of area and the major crops grown are bajra (39.4 %), red gram (39.4 %) and banana (21.2 %). Hullipura (HPR) soil series having moderately shallow soil depth cover 4.96 per cent of area. On this soil crops are horse gram and ragi. Kannigala (KNG) soil series having moderately deep soil depth cover around 4.29 per cent of area in this soil maize (50 %) and sunflower (50 %) are grown. Maddinahundi (MDH) soil series having deep soil cover 5.29 per cent of area. In this soil bajra and horse gram. 4 - The total cost of cultivation and benefit cost ratio (BCR) in study area sunflower range between Rs. 57430/ha in BMB soil (with of 0.98) and Rs. 34393/ha in KNG soil (with BCR of 1.26). - In turmeric the cost of cultivation is Rs. 220347/ha in ARK soil (with BCR of 1.2). - In banana the cost of cultivation is in DRH soil Rs. 115113/ha (with BCR of 1.8). - In groundnut the cost of cultivation is Rs. 39081/ha in ARK soil (with BCR of 1.1). - In sorghum the cost of cultivation is Rs 42790/ha in BMB soil (with BCR of 1.07). - In horse gram the cost of cultivation range between MDH soil is Rs. 20809/ha (with BCR of 1.74) and Rs 32697/ha in HPR soil (with BCR value of 1.3). - In red gram the cost of cultivation is in DRH soil is Rs 21177/ha (with BCR of 1.9) and ragi cost of cultivation Rs in HPR soil is 54721/ha (with BCR of 1.1). - The land management practices reported by the farmers are crop rotation, tillage practices, fertilizer application and use of farm yard manure (FYM). Due to higher wages farmer are following labour saving strategies is not prating soil and water conservation measures. Less ownership of livestock limiting application of FYM. - It was observed soil quality influences on the type and intensity of land use. More fertilizer applications are deeper soils to maximize returns. Suggestions; - Involving farmers is watershed planning helps in strengthing institutional participation. - The per capita food consumption and monthly income is very low. Diversifying income generation activities from crop and livestock production in order to reduce risk related to drought and market prices. - Majority of farmers reported that they are not getting timely support/extension services from the concerned development departments. - By strengthen agricultural extension for providing timely advice improved technology there is scope to increase in net income of farm households. - By adopting recommended package of practices by following the soil test fertiliser recommendation, there is scope to increase yield in bajra (11.2 % to 28.8%), banana (39.8%), red gram (22.1 %), horse gram (14.6% to 35.1 %), ragi (55.8 %), maize (63.0 %), sunflower (24.1 % to 32.5 %), ground nut (50.8 %) and sorghum (37.1%).Karnataka Watershed Development, Under Sujala-III projec