Prevalence, Treatment, and Control of Hypertension in the Elderly: Study on Blood Pressure in Elderly Outpatients (SPAA)

Summary

The prevalence, quality of care, and degree of control of arterial hypertension have been studied in 3858 elderly outpatients (mean age 72.7 ± 4.9 years) randomly recruited from the practice of 444 general practitioners. Hypertension (defined either as blood pressure [BP] = 160 and/or 90 mmHg and/or the presence of antihypertensive treatment) was found in 67.8% of the screened cohort, with a higher prevalence in females than males (73.1% vs 61.0%) and in the older age group (71.1% in those over 80 years vs 64.8% in the 65–69-year group). The hypertensive status was unknown to both the doctors and the patients in 21.4% of cases. Over 90% of the known hypertensives were on treatment with no age-or sex-related differences, but less than 30% of them had BP < 160/90 mmHg. One drug was prescribed to 50.2% of treated patients, only 5.5% were receiving three or more drugs. Low-dosage treatment schedules were frequently used, often associated with non-daily drug administration. Despite the high proportion of subjects on treatment, hypertension in the elderly we studied seemed to be poorly controlled. The study also documents the need for a more rational approach to detection and control of hypertension in this age group, for whom clearly defined recommendations or criteria are lacking.