Impact of Guidelines on Hypertension Control in the Elderly.
Hypertension
cardiovascular diseases
care planning
life style
patient
risk reduction behavior
surveys and questionnaires.
Journal
Current pharmaceutical design
ISSN: 1873-4286
Titre abrégé: Curr Pharm Des
Pays: United Arab Emirates
ID NLM: 9602487
Informations de publication
Date de publication:
2021
2021
Historique:
received:
08
09
2020
accepted:
07
11
2020
pubmed:
9
12
2020
medline:
4
8
2021
entrez:
8
12
2020
Statut:
ppublish
Résumé
Hypertension control is a crucial measure to reduce cardiovascular (CV) risk, and blood pressure (BP) treatment targets have been recently revised to address this issue. However, achieving the recommended goal may be challenging. We aimed to assess the prevalence of uncontrolled hypertension, according to the US hypertension guidelines, among elderly participants in an Italian nationwide epidemiological survey, the relevant clinical correlates, and the agreement with the application of the European guidelines. Elderly (≥65y) volunteers enrolled in an Italian nationwide survey underwent BP measurement using standard protocols. Uncontrolled hypertension was defined as BP≥130/80 mmHg. Agreement of this definition with those from European guidelines (≥140/90 mmHg; ≥140/80 mmHg) was tested using Cohen's kappa. Selfreported information on modifiable/non-modifiable CV risk factors was also collected. Of the 13,162 treated hypertensive elderly, 69.8% had uncontrolled hypertension. They tended to be overweight/obese men with diabetes. Overall agreement between US and European guidelines was poor to good (κ = 0.289, p<0.001 and κ = 0.691, p<0.001 based on the 140/90 and 140/80 mmHg threshold, respectively). Elderly participants with controlled hypertension were more likely to report a history of CV or chronic kidney disease. No difference in lifestyle habits was observed by BP control status. Real-world data identify limited concordance between guidelines in terms of BP target achievement among older hypertensive Italians and highlights the need to spread awareness of the CV risk, especially in the presence of diabetes and obesity.
Sections du résumé
BACKGROUND
Hypertension control is a crucial measure to reduce cardiovascular (CV) risk, and blood pressure (BP) treatment targets have been recently revised to address this issue. However, achieving the recommended goal may be challenging.
OBJECTIVE
We aimed to assess the prevalence of uncontrolled hypertension, according to the US hypertension guidelines, among elderly participants in an Italian nationwide epidemiological survey, the relevant clinical correlates, and the agreement with the application of the European guidelines.
METHODS
Elderly (≥65y) volunteers enrolled in an Italian nationwide survey underwent BP measurement using standard protocols. Uncontrolled hypertension was defined as BP≥130/80 mmHg. Agreement of this definition with those from European guidelines (≥140/90 mmHg; ≥140/80 mmHg) was tested using Cohen's kappa. Selfreported information on modifiable/non-modifiable CV risk factors was also collected.
RESULTS
Of the 13,162 treated hypertensive elderly, 69.8% had uncontrolled hypertension. They tended to be overweight/obese men with diabetes. Overall agreement between US and European guidelines was poor to good (κ = 0.289, p<0.001 and κ = 0.691, p<0.001 based on the 140/90 and 140/80 mmHg threshold, respectively). Elderly participants with controlled hypertension were more likely to report a history of CV or chronic kidney disease. No difference in lifestyle habits was observed by BP control status.
CONCLUSION
Real-world data identify limited concordance between guidelines in terms of BP target achievement among older hypertensive Italians and highlights the need to spread awareness of the CV risk, especially in the presence of diabetes and obesity.
Identifiants
pubmed: 33290195
pii: CPD-EPUB-112143
doi: 10.2174/1381612826666201207230956
pmc: PMC9167062
mid: NIHMS1805113
doi:
Substances chimiques
Antihypertensive Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1952-1959Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL141846
Pays : United States
Informations de copyright
Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.
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