title: Trends in hypertension control among the older population of Spain from 2000 to 2001 to 2008 to 2010: role of frequency and intensity of drug treatment.
abstract: BACKGROUND
  The use of antihypertensive medication and hypertension control has significantly increased during recent decades in some developed countries, but the impact of improved drug treatment on blood pressure (BP) control in the population is unknown.
  
  
  RESULTS
  Data were taken from 2 surveys representative of the population aged ≥ 60 years in Spain conducted with the same methodology in 2000 to 2001 and in 2008 to 2010. BP was measured 6×. The first BP reading was discarded, and the average of the remaining 3 to 5 BP readings was taken for analysis. Hypertension prevalence was 68.7% in 2000 to 2001 and 66.0% in 2008 to 2010. Between both time periods there was an improvement in hypertension awareness (63.6%-67.7%), drug treatment among those aware (84.5%-87.5%), and BP control among treated hypertensives (30.3%-42.9%). Overall, BP control among all hypertensives increased from 16.3% to 25.4%. After adjustment for age, sex, education, hypertension duration, smoking, alcohol consumption, body mass index, sedentary behavior, diabetes mellitus, cardiovascular disease, and visits to the physician through logistic regression, ≈ 7% of the improvement in BP control among all hypertensives was explained by higher hypertension awareness, and 36.2% was explained by a higher treatment rate. Among the treated hypertensives, 22.6% of the progress in BP control was because of the increase in the number of BP medications used in each patient.
  
  
  CONCLUSIONS
  BP control among the older hypertensive population in Spain has improved from 2000 to 2001 to 2008 to 2010 because of a higher treatment rate and more intense antihypertensive drug treatment.
authors.affiliation: From the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ-CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain (J.R.B., B.N.-V., L.M.R., J.J.d.l.C.; E.L.-G., F.R.-A., A.G.); and Hypertension Unit, Research Institute, Hospital 12 de Octubre, Madrid, Spain (L.M.R.). joseramon.banegas@uam.es.
authors.forename: José R
authors.initials: JR
authors.lastname: Banegas
authors.affiliation: From the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ-CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain (J.R.B., B.N.-V., L.M.R., J.J.d.l.C.; E.L.-G., F.R.-A., A.G.); and Hypertension Unit, Research Institute, Hospital 12 de Octubre, Madrid, Spain (L.M.R.).
authors.forename: Beatriz
authors.initials: B
authors.lastname: Navarro-Vidal
authors.affiliation: From the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ-CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain (J.R.B., B.N.-V., L.M.R., J.J.d.l.C.; E.L.-G., F.R.-A., A.G.); and Hypertension Unit, Research Institute, Hospital 12 de Octubre, Madrid, Spain (L.M.R.).
authors.forename: Luis M
authors.initials: LM
authors.lastname: Ruilope
authors.affiliation: From the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ-CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain (J.R.B., B.N.-V., L.M.R., J.J.d.l.C.; E.L.-G., F.R.-A., A.G.); and Hypertension Unit, Research Institute, Hospital 12 de Octubre, Madrid, Spain (L.M.R.).
authors.forename: Juan J
authors.initials: JJ
authors.lastname: de la Cruz
authors.affiliation: From the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ-CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain (J.R.B., B.N.-V., L.M.R., J.J.d.l.C.; E.L.-G., F.R.-A., A.G.); and Hypertension Unit, Research Institute, Hospital 12 de Octubre, Madrid, Spain (L.M.R.).
authors.forename: Esther
authors.initials: E
authors.lastname: López-García
authors.affiliation: From the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ-CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain (J.R.B., B.N.-V., L.M.R., J.J.d.l.C.; E.L.-G., F.R.-A., A.G.); and Hypertension Unit, Research Institute, Hospital 12 de Octubre, Madrid, Spain (L.M.R.).
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
authors.affiliation: From the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ-CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain (J.R.B., B.N.-V., L.M.R., J.J.d.l.C.; E.L.-G., F.R.-A., A.G.); and Hypertension Unit, Research Institute, Hospital 12 de Octubre, Madrid, Spain (L.M.R.).
authors.forename: Auxiliadora
authors.initials: A
authors.lastname: Graciani
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects*; D016009:Chi-Square Distribution; D004359:Drug Therapy, Combination; D017723:Drug Utilization Review; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010818:Practice Patterns, Physicians' / Q000639:trends*; D015995:Prevalence; D017064:Process Assessment, Health Care / Q000639:trends*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: aging; epidemiology; hypertension; population studies; therapeutics