Abstract 436: Over - Versus Under-Treatment of Older Hypertensives in Canada
In a re-analysis of data collected during the 2006 Ontario Survey on the Prevalence and Control of Hypertension (Leenen et al, CMAJ 2008), we focussed on the actual blood pressures in treated and untreated older and middle-aged hypertensives. In the older (60-79 years of age) population of 1,426,752 subjects, using traditional definitions the prevalence of hypertension was 49% compared to 21% in the middle-aged (40-59 years of age) population. Hypertension treatment and control rates were similarly high in middle-aged and older hypertensives at 67% and 64% respectively. 39% of older hypertensives were treated with a single antihypertensive drug, and of these 54% had a systolic BP level of < 130 mmHg, and 23% had a systolic BP < 120 mmHg. Of the 61% treated with combination therapy, 44% had a systolic BP < 120 mmHg. 13% of older hypertensives were untreated, and out of those approximately 90% had Stage 1 hypertension, with ~70% without additional risk factors.
Considering that monotherapy may lower systolic BP by < 10 mmHg, these findings suggest that there may be a major problem of over-diagnosis and/or over-treatment of hypertension in older adults overestimating substantially the actual prevalence of hypertension, creating an unnecessary burden on the health care system and exposing many older subjects to unnecessary risks of drug therapy.
Author Disclosures: G. Fodor: None. P. Baker: None. L. Chen: None. F. Leenen: C. Other Research Support (includes receipt of drugs, supplies, equipment or other in-kind support); Modest; Pfizer Canada, the University of Ottawa Heart Institute Foundation and the Canadian Institutes of Health Research.
- © 2014 by American Heart Association, Inc.