Prevalence, awareness, and management of hypertension, dyslipidemia, and diabetes among United States adults aged 65 and older.
BACKGROUND
Adults aged 65 and older are disproportionately affected by hypertension, dyslipidemia, and diabetes, which are established risk factors for cardiovascular disease (CVD). Although risk reduction strategies among older adults, including control of CVD risk factors, can lead to a decline in premature CVD morbidity and mortality, the prevalence of these risk factors has generally increased in the past decade among elders and risk factor control rates have been suboptimal. We assess prevalence, awareness, treatment, and control rates among U.S. adults aged 65 and older with respect to hypertension, dyslipidemia, and diabetes and describe predictors associated with awareness and management of these factors.


METHODS
Analysis of nationally representative data collected from adults aged 65 and older (n = 3,810) participating in the National Health and Nutrition Examination Survey 1999-2004.


RESULTS
Women have a significantly higher prevalence of hypertension than men (76.6% vs 63.0%) and a significantly lower rate of control when treated pharmacologically (42.9% vs 57.9%). Dyslipidemia prevalence is 60.3% overall, and women are significantly more likely to be aware of their condition than men (71.1% vs 59.1%). Diabetes affects 21.2% of older adults, and 50.9% of prevalent cases are treated pharmacologically. Goal attainment among those treated is problematic for all three conditions-hypertension (48.8%), dyslipidemia (64.9%), and diabetes (50.4%). Having two or more doctor visits annually is associated with goal attainment for dyslipidemia.


CONCLUSIONS
Knowledge of cardiovascular health in older adults and understanding gender gaps in awareness can help physicians and policymakers improve disease management and patient education programs.
McDonald
Margaret
M
Evidence-Based Strategies-Comparative Effectiveness and Population Studies, Pfizer Inc., 235 East 42nd Street, New York, NY 10017, USA. margaret.m.mcdonald@pfizer.com
Hertz
Robin P
RP
Unger
Alan N
AN
Lustik
Michael B
MB
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001364:Awareness; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D050171:Dyslipidemias / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D015577:Geriatric Assessment; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology