title: Hypertension in older patients, a retrospective cohort study.
abstract: It is unknown to what extent General Practitioners (GPs) manage hypertension (HT) differently in older patients, as compared to younger age groups. The purpose of our study was to compare HT management in older patients to younger age groups.
  
  
  
  We performed a retrospective cohort study of patients of 159 GP's practices in the Integrated Primary Care Information (IPCI) database. The study period lasted from September 2010 through December 2012. The study population consisted of all patients aged 60 years or older with at least one blood pressure (BP) measurement during the inclusion period, without pre-existent HT, diabetes mellitus (DM) or atherosclerotic cardiovascular disease at time of study start. Study outcomes were a diagnosis of HT within one month after cohort entry and the use of antihypertensive medication within 4 months after cohort entry in HT diagnosed patients. We compared the incidence of outcomes between the age groups, stratified by systolic blood pressure (SBP). Logistic regression analysis was used to assess the influence of age-adjusted SBP Z-scores, age and gender on the outcomes.
  
  
  
  We included 19,500 patients from 159 GP's practices of whom 1,181 (6.1 %) were newly diagnosed with HT. Corrected for age-adjusted SBP, older patients were less likely to be diagnosed with HT (odds ratio per year age increase 0.98, p < 0.001). Corrected for age-adjusted SBP, no significant effect of age on the probability of treatment in newly diagnosed HT patients was observed (p = 0.82).
  
  
  
  This study showed that GPs are less inclined to diagnose HT with increasing patient age, but do not withhold treatment when they diagnose HT in older patients.
authors.affiliation: Department of Medical Informatics, Erasmus Medical Centre, P.O. Box 2040, 3015 CA, Rotterdam, The Netherlands. c.g.h.blok@erasmusmc.nl.
authors.forename: C G H
authors.initials: CG
authors.lastname: Blok
authors.affiliation: Department of Medical Informatics, Erasmus Medical Centre, P.O. Box 2040, 3015 CA, Rotterdam, The Netherlands.
authors.forename: M A J
authors.initials: MA
authors.lastname: de Ridder
authors.affiliation: Department of Medical Informatics, Erasmus Medical Centre, P.O. Box 2040, 3015 CA, Rotterdam, The Netherlands.
authors.forename: K M C
authors.initials: KM
authors.lastname: Verhamme
authors.affiliation: Department of Medical Informatics, Erasmus Medical Centre, P.O. Box 2040, 3015 CA, Rotterdam, The Netherlands.
authors.forename: P W
authors.initials: PW
authors.lastname: Moorman
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D001795:Blood Pressure Determination / Q000379:methods; D005260:Female; D058005:General Practitioners / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D063868:Patient Outcome Assessment; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies
chemical_list: D000959:Antihypertensive Agents
keywords: Age factors; Aged 80 and over; Electronic health records; General practice; Hypertension