[Differences between office and ambulatory control of hypertension in very elderly patients. The CARDIORISC - MAPAPRES project].
OBJECTIVE
Hypertension is highly prevalent in the very elderly. We studied control rates of hypertension according to clinic blood pressure (BP) and ambulatory BP monitoring (ABPM) in treated hypertensives aged > or =80 years.


METHODS
Data came from the Spanish Society of Hypertension ABPM Registry (CARDIORISC - MAPAPRES project), which comprises a nation-wide network of more than 1,000 physicians sending standardized ABPM registries via web. Between June 2004 and April 2007 we obtained a 33.829-patient database. Control of hypertension was defined at the clinic when office BP was <140/90mmHg and at the ABPM when mean BP during the 24-h period was <130/80mmHg.


RESULTS
We identified 2,311 patients (6.8%) aged > or =80 years. Mean age (SD) was 83.1 (3.2) years and 63% were women. Control of clinic BP was observed in 21.5% of cases (95%CI: 19.1-23.9) and control of 24-h BP in ABPM was 42.1% (95%CI: 39.7-45.3). Prevalence of masked hypertension was 7.0% (95%CI: 6.0-8.0) and prevalence of office-resistant control (white coat) was 27.6% (95% CI: 25.7-29.4). Diabetes, kidney disease, and duration of hypertension were associated with lack of control in ABPM.


CONCLUSIONS
In very old hypertensives, control of clinic BP was 21.5% but ambulatory-based hypertension control was 42.1%. Physicians should be aware that the likelihood of misestimating BP control is high in these subjects. A wider use of ABPM in the elderly with hypertension should be considered.
Llisterri
José L
JL
Centro de Salud Joaquín Benlloch, Valencia, España. jllisterric@medynet.com
Alonso
Francisco J
FJ
Gorostidi
Manuel
M
Sierra
Cristina
C
de La Sierra
Alejandro
A
Banegas
José R
JR
Segura
Julián
J
Sobrino
Javier
J
De La Cruz
Juan J
JJ
Madruga
Felipe
F
Aranda
Pedro
P
Redon
Josep
J
Ruilope
Luis M
LM
D000369:Aged, 80 and over; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000517:prevention & control; D008297:Male; D009819:Office Visits; D012042:Registries