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 (2020). Blood pressure control and complex health conditions in older adults: impact of recent hypertension management guidelines. (In Press). Journal of human hypertension Nature Publishing Group 10.1038/s41371-020-0334-4

[img] Text
Anker JHumHypertens 2020_epub.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (782kB) | Request a copy
[img] Text
Anker JHumHypertens 2020_AAM.pdf - Accepted Version
Restricted to registered users only until 29 October 2020.
Available under License Publisher holds Copyright.

Download (473kB) | 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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Anker, Daniela; Zwahlen, Marcel; Rodondi, Nicolas and Chiolero, Arnaud

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0950-9240

Publisher:

Nature Publishing Group

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

08 May 2020 20:35

Last Modified:

11 May 2020 07:45

Publisher DOI:

10.1038/s41371-020-0334-4

PubMed ID:

32346124

BORIS DOI:

10.7892/boris.143927

URI:

https://boris.unibe.ch/id/eprint/143927

Actions (login required)

Edit item Edit item
Provide Feedback