Blood pressure control and complex health conditions in older adults: impact of recent hypertension management guidelines.

Anker, Daniela; Santos-Eggimann, Brigitte; Zwahlen, Marcel; Santschi, Valérie; Rodondi, Nicolas; Wolfson, Christina; Chiolero, Arnaud (2021). Blood pressure control and complex health conditions in older adults: impact of recent hypertension management guidelines. Journal of human hypertension, 35(3), pp. 280-289. Nature Publishing Group 10.1038/s41371-020-0334-4

Preview	Text Anker JHumHypertens 2020_AAM.pdf - Accepted Version Available under License Publisher holds Copyright. Download (473kB) | Preview
	Text Anker_JHumHypertens_2021.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (772kB) | Request a copy

The American College of Cardiology and the American Heart Association (ACC/AHA) 2017 guidelines for hypertension management lowered blood pressure (BP) thresholds to 130/80 mmHg to define hypertension while the European Society of Cardiology and the European Society of Hypertension (ESC/ESH) 2018 guidelines retained 140/90 mmHg. Both guidelines recommend adapting management for older patients with complex health conditions, without however clear indications on how to adapt. Our aims were to assess the impact of lowering BP thresholds on the prevalence of elevated BP and BP control, as well as the proportion of participants with a complex health condition across these BP categories. We used data from 3210 participants in the Lausanne cohort Lc65+ aged between 67 and 80 years. Hypertension diagnosis and antihypertensive medication use were self-reported. BP was measured three times at one visit. Some 51% of participants reported having hypertension and 44% reported taking antihypertensive medication. Compared with ESC/ESH thresholds, the prevalence of measured elevated BP was 24% percentage points higher and BP control was 24% percentage points lower using ACC/AHA thresholds. About one out of two participants with elevated BP and four out of five participants with uncontrolled BP had a complex health condition, i.e., frailty, multimorbidity, or polypharmacy. To comply with ACC/AHA guidelines, considerable effort would be required to reach BP control. This is a serious challenge because a large share of hypertensive older adults has complex health conditions, a type of patients for whom there is no strong evidence on how to manage hypertension.

Interest & Impact

Downloads

290 since deposited on 08 May 2020
139 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item