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Factors associated with treatment and control of hypertension in a healthy elderly population free of cardiovascular disease: a cross-sectional study

Chowdhury, EK, Nelson, MR ORCID: 0000-0001-9941-7161, Ernst, ME, Margolis, KL, Beilin, LJ, Johnston, CI, Woods, RL, Murray, AM, Wolfe, R, Storey, E, Shah, RC, Lockery, JE, Tonkin, AM, Newman, AB, Williamson, JD, Abhayaratna, WP, Stocks, NP, Fitzgerald, SM, Orchard, SG, Trevaks, RE, Donnan, GA, Grimm, R, McNeil, JJ and Reid, CM 2019 , 'Factors associated with treatment and control of hypertension in a healthy elderly population free of cardiovascular disease: a cross-sectional study' , American Journal of Hypertension, vol. 33, no. 4 , pp. 350-361 , doi: 10.1093/ajh/hpz192.

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Abstract

Background: Despite readily available treatments, control of blood pressure (BP) with population ageing remains suboptimal. Further, there are gaps in the understanding of the management of high BP in the aged. We explored antihypertensive treatment and control among elderly hypertensive participants free from overt cardiovascular disease (CVD), and identified factors related to both 'untreated' and 'treated but uncontrolled' high BP.Methods: We analyzed baseline data from 19,114 individuals aged ≥65-years enrolled from Australia and US in the ASPirin in Reducing Events in the Elderly (ASPREE) study. Hypertension was defined as an average systolic/diastolic BP ≥140/90mmHg and/or the use of any BP lowering medication. 'Controlled hypertension' was defined if participants were receiving antihypertensive medication and BP Results: Overall, 74% (14,213/19,114) of participants were hypertensive; and of these 29% (4,151/14,213) were untreated. Among those treated participants, 53% (5,330/10,062) had BP≥140/90 mmHg. Participants who were untreated were more likely to be men, have higher educational status, and be in good physical health, and less likely to have significant comorbidities. The factors related to 'treated but uncontrolled' BP included older age, male, Black race (versus White), using antihypertensive monotherapy (versus multiple) and residing in Australia (versus US).Conclusion: High levels of 'untreated' and 'treated but uncontrolled' BP occur in healthy elderly people without CVD , suggesting there are opportunities for better BP control in the primary prevention of CVD in this population.

Item Type: Article
Authors/Creators:Chowdhury, EK and Nelson, MR and Ernst, ME and Margolis, KL and Beilin, LJ and Johnston, CI and Woods, RL and Murray, AM and Wolfe, R and Storey, E and Shah, RC and Lockery, JE and Tonkin, AM and Newman, AB and Williamson, JD and Abhayaratna, WP and Stocks, NP and Fitzgerald, SM and Orchard, SG and Trevaks, RE and Donnan, GA and Grimm, R and McNeil, JJ and Reid, CM
Keywords: BP control, hypertension, antihypertensive, elderly
Journal or Publication Title: American Journal of Hypertension
Publisher: Elsevier Science Inc
ISSN: 0895-7061
DOI / ID Number: 10.1093/ajh/hpz192
Copyright Information:

© American Journal of Hypertension 2019

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