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Age and Ageing 2001; 30: 73-76
© 2001, British Geriatrics Society

Short report

Management of older patients with hypertension in primary care: improvement on the rule of halves

Sandra Duggan, Martin P. Eccles, Nicholas Steen, Samantha Jones1 and Gary A. Ford,1

Centre for Health Services Research,
1 Departments of Medicine (Geriatrics) and Pharmacological Sciences, University of Newcastle upon Tyne NE2 4HH, UK

Abstract

Objectives: the benefits of treatment of hypertension in older people are well-established but implementation of this knowledge may be sub-optimal. We have determined recent primary care management of older people with hypertension.

Methods: we examined health records (n=6986) of a 1 in 7 sample of patients aged 65–80 years from a random sample of practices (n=51) in the former Northern Region of the UK, stratified by health authority, for the previous 6 years. We recorded documented risk factors, diagnosis of hypertension, three most recent blood pressure readings, current drug therapy and previous blood pressure lowering therapy, and presence of coexistent pathology.

Results: blood pressure was defined as hypertensive (>=160/>=90 mmHg; one or both values above these limits), normotensive or undetermined using a validated algorithm. In 30% of patients, blood pressure status was undetermined. Thirty-five percent of subjects were found to be hypertensive. Of these, 70% were receiving antihypertensive treatment but only 30% of treated patients had controlled (<150 and 90 mmHg) and 13% well controlled (<140 and 85 mmHg) blood pressure. In all, 14% of older hypertensive patients were detected, treated and had their hypertension controlled. There were significant differences between practices in the proportion of hypertensive patients treated (P<0.001) and in the proportion of hypertensive patients whose blood pressure was controlled (P<0.01).

Conclusions: treatment of hypertension in older people in primary care has improved in terms of detection and treatment but in only one-third of patients is high blood pressure controlled. There remain important opportunities for prevention of stroke and myocardial infarction in this age group through achieving improved blood pressure control.

Keywords: audit, blood pressure measurement, hypertension, primary care


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Age Ageing, March 1, 2006; 35(2): 178 - 182.
[Abstract] [Full Text] [PDF]


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