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(Hypertension. 1998;31:552.)
© 1998 American Heart Association, Inc.
Scientific Contributions |
Trends in Hypertension Prevalence, Treatment, and Control In a Well-Defined Older Population
From the University of Rochester Medical Center, Rochester, New York (WHB), and the Kaiser Permanente Center for Health Research, Portland, Oregon (JPM, KLPL).
Correspondence to William H. Barker, MD, Department of Community and Preventive Medicine, Box 644, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, New York 14642. E-mail: Barker{at}prevmed.rochestr.edu
To assess medical attention focused on hypertension (HBP) in the elderly, this study examines trends in HBP prevalence, treatment, and control status in a defined population of persons 
65 years of age enrolled in a large HMO. Random samples of approximately 400 persons were drawn for the years 1967, 1974, 1981, and 1988. First recorded ambulatory pressures, available on over 90% of subjects in each period, were obtained from medical records. Prevalence of HBP (SBP 160 and/or DBP 95, and/or taking anti-HBP drugs) ranged between 44% to 53%. Proportion with HBP on treatment increased from 25% in 1967 to 60% in 1988 (P<.001); proportion on treatment and controlled (SBP<160, DBP<95) increased from 8% to 34% (P<.001). Mean population SBP declined from 155.2 in 1967 to 144.0 in 1988 (P<.001); mean DBP declined from 85.2 to 81.2 (P<.001). Proportion with isolated systolic hypertension (ISH) (SBP160, DBP<90) remained unchanged at 12% to 14%. Use of diuretics and adrenergic antagonist agents declined while use of beta blockers and newer classes of anti-HBP drugs increased significantly among treated hypertensives in the 1980s. These findings parallel HBP trends in younger adults from National Health Survey data though we find evidence of a substantial gap in addressing the problem in the elderly, who constitute the population at greatest risk of cardiovascular complications of HBP.
Key Words: hypertension • elderly • epidemiology • prevalence • trends
Abbreviations: HBP = hypertension • anti-HBP = antihypertensive • SBP = systolic blood pressure • DBP = diastolic blood pressure • ISH = isolated systolic hypertension • ACE = angiotensin converting enzyme • CAs = calcium antagonsts
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