Hypertension magnitude and management in the elderly population of Spain.
OBJECTIVE
The present study assessed the prevalence, awareness, treatment and control of hypertension among the elderly population of Spain.


METHODS
Based on a nationally representative sample of 4009 individuals aged 60 years, two sets of six blood pressure measurements were obtained by trained observers at each subject's home, using standardized methods. In each set, three mercury-based measurements were alternated with three automated measurements.


RESULTS
The mean systolic blood pressure (SBP)/diastolic blood pressure (DBP) was 143/79 mmHg, and the pulse pressure was 64 mmHg. The prevalence rate of hypertension (SBP 140 mmHg, DBP 90 mmHg, or current drug treatment) was 68.3%. No result obtained was sensitive to a particular measurement device. Of the hypertensives, 65% were aware of their condition, 55.3% were treated and 16.3% were controlled. Among treated hypertensives, SBP control (32.2%) was much lower than DBP control (82.3%). Control was lower in men than in women, in older than in younger subjects, and in those with lowest than in those with higher educational levels. About 57% of uncontrolled treated hypertensives were on monotherapy. Weight loss was among the least heeded items of advice (39% among overweight hypertensives).


CONCLUSIONS
Hypertension is a major public health problem in elderly Spaniards. Most hypertensives had their hypertension uncontrolled. Greater emphasis should be laid on the most disadvantaged (the older, men, and those with lowest education) in terms of hypertension management, and on reinforcing weight loss and combining drugs for enhanced hypertension control.
Banegas
José R
JR
Department of Preventive Medicine and Public Health, Autonomous University of Madrid, Madrid, Spain. joseramon.banegas@uam.es
Rodríguez-Artalejo
Fernando
F
Ruilope
Luis M
LM
Graciani
Auxiliadora
A
Luque
Manuel
M
de la Cruz-Troca
Juan J
JJ
García-Robles
Rafael
R
Tamargo
Juan
J
Rey-Calero
Juan
J
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D001795:Blood Pressure Determination; D003430:Cross-Sectional Studies; D004039:Diet, Sodium-Restricted; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D010353:Patient Education as Topic; D015995:Prevalence; D012307:Risk Factors; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage; D013030:Spain / Q000453:epidemiology
D000959:Antihypertensive Agents; D017673:Sodium Chloride, Dietary