Prevalence, awareness, treatment and control of hypertension in the elderly: results from a population survey

Abstract

Prevalence, awareness, treatment and control of hypertension were assessed in 1032 (90%) of 1147 elderly (⩾65 years) inhabitants of three Italian villages. Blood pressure (BP) was measured at home on two separate occasions following a standardised protocol. Persons taking antihypertensive drugs or with BP values ⩾140/90 mm Hg were considered as affected by hypertension. Prevalence of hypertension was 64.8%, with higher rates in women than men, and in those aged 75–84 than in those aged 65–74. Diabetes, strokes and hypercholesterolaemia were more frequent in hypertensive than normotensive people, whereas cardiac diseases, overweight and smoking did not differ significantly between hypertensive and normotensive people. Of the 669 hypertensive patients, 439 (65.6%) were aware of their hypertension, 398 (59.5%) were being treated, and 70 (10.5%) had their hypertension controlled. Of the 230 unaware patients, 201 (87.4%) had had their BP measured in the previous year. Of these, 174 (86.6%) had stage 1 hypertension, while 27 had stage 2 hypertension with SBP values <170 mm hg. overall, the patients with stage 1 hypertension accounted for 68.3% of the untreated and 50.5% of the treated patients. the use of a single drug was more frequent in patients with controlled (97.1%) or stage 1 (97.0%) than with stages 2–3 (18.9%) hypertension. the drugs prescribed most were angiotensin-converting enzyme (ace) inhibitors (45%), followed by diuretics (43%). as our findings suggest that bp values can be effectively reduced by treating or increasing drug treatment in stage 1 hypertensive patients, data on safety and effectiveness of this policy are urgently needed.