Management of hypertension in the oldest old: a study in primary care in New Zealand.
BACKGROUND
The benefits of blood pressure (BP) lowering are well established except in the oldest old, and suboptimal control of hypertension has been found in many different populations.


OBJECTIVE
To assess the frequency of hypertension and its adequacy of management in the oldest old in primary care.


METHODS
a cross-sectional study.


METHODS
Sixty-seven general practitioners (GPs) in three urban centres in New Zealand.


METHODS
We conducted structured reviews of medical records for all ambulatory people aged > or = 80 years who were registered with a participating GP. Hypertensive status and BP control were classified according to standard criteria. Logistic regression analyses were used to identify independent factors for BP control.


RESULTS
Medical records of 3,068 people (mean age 85 years, 64% female) revealed 56% to be hypertensive, of whom 94% were on treatment and 58% had controlled BP levels. Major co-morbid conditions were common among hypertensive people, and half of them had associated target organ damage. Histories of stroke, heart disease and hypercholesterolaemia were independent factors for good BP control.


CONCLUSIONS
A large proportion of the oldest old were currently receiving anti-hypertensive therapy, and most had adequately controlled BP. Previous vascular disease was the most important factor for both BP treatment and control. These findings indicate a high level of uptake of cardiovascular guidelines for older people.
Senior
Hugh
H
Clinical Trials Research Unit, School of Population Health, University of Auckland, Auckland, New Zealand. h.senior@ctru.auckland.ac.nz
Anderson
Craig S
CS
Chen
Mei-Hua
MH
Haydon
Ron
R
Walker
Dinah
D
Fourie
Dean
D
Lillis
Steven
S
Gommans
John
J
D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D005260:Female; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D011320:Primary Health Care; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications
D000959:Antihypertensive Agents