Blood pressure control poor in elderly, says Northwestern researcher

n the 60-to-79 age group, about 59 percent had high blood pressure. In the group aged 80 and older, over 70 percent had high blood pressure.

The overall prevalence of treatment was around 66 percent. Treatment rates increased substantially from the younger -to-old age group (57 percent to 72 percent), with no further increase in the "old-old," 80-and-over group (73 percent).

However, the number of antihypertensive medications used was similar across all age groups, with two thirds of treated hypertensive patients using only one medication; 25 percent using two medications; and fewer than 10 percent using three medications, Lloyd-Jones said.

Lloyd-Jones noted that the use of thiazide diuretics increased steadily with advancing age, but remained suboptimal.

In the 80-and-older group, only 22 percent of men and 32 percent of women with hypertension were using thiazide diuretics for therapy, despite the fact that thiazides have been shown to be extremely effective in older hypertensive patients.

The investigators also showed that the risks associated with hypertension for development of cardiovascular disease, major coronary events (such as heart attack) and congestive heart failure were substantially higher in the oldest age group compared with those in younger people with high blood pressure.

Lloyd-Jones said there are several major public health implications to be drawn from the study:

  • The elderly have the highest prevalence of hypertension and the risks associated with hypertension increase with advancing age.
  • Current rates of blood pressure control are unacceptably low for the oldest hypertensives, and particularly women.
  • Poor control is due in part to an inadequate number of medications and, perhaps, to poor selection of drug classes.

According the recent Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pres

Contact: Elizabeth Crown
Northwestern University

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