Hypertension in the very old; prevalence, awareness, treatment and control: a cross-sectional population-based study in a Spanish municipality.
BACKGROUND
Information on hypertension in the very elderly is sparse. Until recently evidence of benefits from pharmacological treatment was inconclusive. We estimated the prevalence of hypertension in subjects aged 80 or more, the proportion of awareness, treatment and control. Explanatory variables associated with good control were also studied.


METHODS
Cross sectional, population-based study, conducted in Martorell, an urban Spanish municipality, in 2005. By simple random sampling from the census, 323 subjects aged 80 or more were included. Patients were visited at home or in the geriatric institution and after giving informed consent, the study variables were collected. These included: supine and standing blood pressure and information about diagnosis and treatment of hypertension. The estimation and 95% confidence interval were obtained and a logistic regression model was used to study explanatory variables associated with blood pressure below 140/90 mm Hg.


RESULTS
The prevalence of hypertension was 72.8% (95%CI: 69.5-76.6%) and 93% of the patients were aware of this condition, of whom 96.3% (95%CI: 93.65-97.9%) had been prescribed pharmacological treatment and 30.7% (95%CI: 25.8 - 36.1%) had blood pressure below 140/90 mm Hg. Some of the patients (43%) had one antihypertensive drug and 39.5% had two in combination. Explanatory variables associated with blood pressure below 140/90 mm Hg included prescription of a diuretic, OR: 0.31 (95%CI: 0.14-0.66), and history of ischemic heart disease, OR: 0.21 (95%CI: 0.1-0.47).


CONCLUSIONS
The prevalence of hypertension in population aged 80 or more was over 70%. Most patients were aware of this condition and they had antihypertensive medication prescribed. Approximately one third of treated patients had blood pressure below 140/90 mm Hg. Patients with heart disease and with diuretics had more frequently blood pressure below this value.
Aguado
Alba
A
CAP Sagrada Familia, Consorci Sanitari Integral, Barcelona, Spain. alba.aguado@sanitatintegral.org
López
Flora
F
Miravet
Sonia
S
Oriol
Pilar
P
Fuentes
M Isabel
MI
Henares
Belén
B
Badia
Teresa
T
Esteve
Lluis
L
Peligro
Javier
J
D000367:Age Factors; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome
D000959:Antihypertensive Agents