[Control of hypertension in elderly patients receiving primary care in Spain]. / Control de la hipertensión arterial en la población española > or = 65 años asistida en atención primaria.

INTRODUCTION AND OBJECTIVES: Little information is available about the control of arterial hypertension in the elderly population. The aim of this study was to investigate hypertension control, factors associated with poor control, and general practitioners' responses to poor control in a large sample of hypertensive patients aged 65 years or older receiving primary care in Spain. PATIENTS AND METHOD: A cross-sectional study of elderly hypertensive patients taking antihypertensives was carried out. Blood pressure was measured in the standard manner. Blood pressure control was regarded as optimum if pressure averaged less than 140/90 mm Hg or, in diabetics, less than 130/85 mm Hg. RESULTS: The study included 5970 patients (mean age, 72.4 years; 62.8% women). Both systolic and diastolic blood pressures were well controlled in 33.5% of patients, systolic blood pressure alone in 35.5%, and diastolic blood pressure alone in 76.2%. Blood pressure control was found to be good more frequently when it was assessed in the evening (39.8%; P<.001), and when patients had taken treatment on the day of assessment (35.1%; P <.001). Some 12.9% of diabetics had pressures less than 130/85 mmHg and 9.7% had pressures less than 130/80 mmHg. General practitioners modified their therapeutic approach with only 17.2% of poorly controlled patients. CONCLUSIONS: Arterial blood pressure control was optimum in only three out of 10 Spanish hypertensive patients aged 65 years or older. Blood pressure control assessment was significantly influenced by surgery hours and by the timing of antihypertensive intake. General practitioners' therapeutic responses to poor control were too conservative.

Control de la hipertensión arterial en la población española ≥ 65 años asistida en atención primaria / Control of hypertension in elderly patients receiving primary care in Spain

Introducción y objetivos. Se dispone de escasa información sobre el control de la hipertensión arterial en la población de mayor edad. El objetivo de este estudio fue analizar el grado de control de la hipertensión arterial en una amplia muestra de españoles ≥ 65 años asistidos en atención primaria, los factores asociados al mal control yla conducta del médico ante esa situación. Pacientes y método. Estudio transversal realizado en hipertensos ≥ 65 años tratados farmacológicamente. Se midió la presión arterial (PA) siguiendo normas estandarizadas y se consideró que había un control óptimo si era <140/90 mmHg (en diabéticos < 130/85 mmHg).Resultados. Se incluyó a 5.970 pacientes (edad media,72,4 años; 62,8%, mujeres). El 33,5% presentó un buen control sistólico-diastólico, el 35,5% sólo sistólico yel 76,2% únicamente diastólico. El grado de control fue significativamente mayor (p < 0,001) por las tardes(39,8%) y en los pacientes que habían tomado la medicación antihipertensiva el día de la visita (35,1%). El 12,9% de los diabéticos mostró una PA < 130/85 mmHg y el9,7% < 130/80 mmHg. El médico modificó su conducta terapéutica en el 17,2% de los no controlados. Conclusiones. Tan sólo 3 de cada 10 hipertensos españoles≥ 65 años tienen la PA bien controlada. Hay diferencias apreciables en el grado de control según el horario de consulta y la toma previa de antihipertensivos. La conducta terapéutica del médico ante el mal control es demasiado tolerante

Introduction and objectives. Little information is available about the control of arterial hypertension in the elderly population. The aim of this study was to investigate hypertension control, factors associated with poor control, and general practitioners’ responses to poor control in a large sample of hypertensive patients aged 65 years or older receiving primary care in Spain. Patients and method. A cross-sectional study of elderly hypertensive patients taking anti-hypertensives was carried out. Blood pressure was measured in the standard manner. Blood pressure control was regarded as optimum if pressure averaged less than 140/90 mm Hg or, in diabetics, less than 130/85 mm Hg. Results. The study included 5970 patients (mean age,72.4 years; 62.8% women). Both systolic and diastolic blood pressures were well controlled in 33.5% of patients, systolic blood pressure alone in 35.5%, and diastolic blood pressure alone in 76.2%. Blood pressure control was found to be good more frequently when it was assessed in the evening (39.8%; P<.001), and when patients had taken treatment on the day of assessment (35.1%; P<.001). Some 12.9% of diabetics had pressures less than130/85 mmHg and 9.7% had pressures less than 130/80mmHg. General practitioners modified their therapeutic approach with only 17.2% of poorly controlled patients. Conclusions. Arterial blood pressure control was optimum in only three out of 10 Spanish hypertensive patients aged 65 years or older. Blood pressure control assessment was significantly influenced by surgery hours and by the timing of antihypertensive intake. General practitioners’ therapeutic responses to poor control were too conservative