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Treatment of hypertension in the elderly: data from an international cohort of hypertensives treated by cardiologists

Journal of Human Hypertension volume 27, pages 131–137 (2013)Cite this article

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Abstract

Hypertension in the elderly is a major risk factor for cardiovascular disease. We aimed to analyze determinants of blood pressure (BP) control across different age groups. Population of a large global survey on hypertension treatment and control including 18 927 patients was analyzed. A logistic regression analysis was conducted to estimate BP control rates and the prevalence of antihypertensive drug usage according to age. Systolic BP control decreased from 29.6% (95% confidence intervals (CI) 26.0;33.5) at 18–40 years to 22.4% (20.8;24.2) at >75 years (P<0.0001), and diastolic BP control increased from 31.6% (27.9;35.6) to 57.3% (55.2;59.3), respectively (P<0.0001). BP control was worse in diabetic patients, but did not differ substantially with co-morbid conditions, except for a better control in patients with myocardial infarction (MI) (P<0.05). The use of ⩾3 antihypertensive drugs increased with age from 16.1 to 37.8% (P<0.0001) due to a more frequent use of loop diuretics (P<0.0001), thiazides (P<0.0001), angiotensin-converting enzyme (ACE) inhibitors (P<0.0001) and calcium channel blockers (P<0.0001). About one third of patients received non-guideline-recommended drug–drug combinations. BP control is largely unsuccessful with increasing age. Owing to frequent inadequacies in the combination of antihypertensive drugs, future guidelines and educational programs should devote increased attention to the choice of optimal drug–drug combinations in the elderly.

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Acknowledgements

We would like to thank Sam Zhong for the statistical support provided. This study was supported by Sanofi Aventis, Paris, France.

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Authors and Affiliations

  1. Institute for Clinical Pharmacology, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany

    M Thoenes

  2. Sanofi Aventis, Global Medical Affairs, Paris, France

    M Thoenes

  3. Sanofi Aventis, Medical Affairs, Meyrin, Switzerland

    D Spirk

  4. Klinik für Innere Medizin III, Saarland University, Homburg/Saar, Germany

    M Böhm & F Mahfoud

  5. SUNY Downstate Medical Center, New York, NY, USA

    L Thevathasan

  6. Institute for Cardiovascular Pharmacology and Epidemiology, Mahlow, Germany

    L Thevathasan & P Bramlage

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  1. M Thoenes
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Correspondence to M Thoenes.

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Competing interests

MT and DS are employees of the sponsor of the study. LT has been an employee of the sponsor until 06/2010. MB received speaker honoraria from Sanofi Aventis and Novartis and is supported by the Deutsche Forschungsgemeinschaft (KFO 196) and the Ministry of Science and Economy of the Saarland. FM is supported by the Deutsche Hochdruckliga and is supported by the Deutsche Forschungsgemeinschaft (KFO 196) and the Ministry of Science and Economy of the Saarland. WK and PB have been consulting for Sanofi Aventis and received speaker honoraria and research support.

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Thoenes, M., Spirk, D., Böhm, M. et al. Treatment of hypertension in the elderly: data from an international cohort of hypertensives treated by cardiologists. J Hum Hypertens 27, 131–137 (2013). https://doi.org/10.1038/jhh.2011.114

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  • DOI: https://doi.org/10.1038/jhh.2011.114

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