Despite evidence-based guidelines, systolic blood pressure remains inadequately controlled in older hypertensive adults

Antikaínen, Riitta; Kastarinen, Mika; Jousilahti, Pekka; Peltonen, Markku; Laatikainen, Tiina; Beckett, Nigel; Peters, Ruth; Jokelainen, Jari; Barengo, Noël C.; Tuomilehto, Jaakko

doi:10.1038/jhh.2009.85

Cited by 18 publications

(9 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Better hypertension control, especially among elderly people, might provide the benefit of reducing the pace of other degenerative processes (29). Similar improvements in hypertension management and control that are demonstrated in this study have been shown in other settings such as in the UK (30) and Finland (31). The improvements are not only observed in developed settings.…”

Section: Discussionsupporting

confidence: 88%

Trends of blood pressure levels and management in Västerbotten County, Sweden, during 1990–2010

Carlberg

Weinehall

et al. 2012

Global Health Action

View full text Add to dashboard Cite

BackgroundAvailability of longitudinal data on hypertension and blood pressure levels are important to assess changes over time at the population level. Moreover, detailed information in different population sub-groups is important to understand inequity and social determinants of blood pressure distribution in the population.ObjectivesThe objectives of this study are to: (1) describe the trends of population blood pressure levels in men and women between different educational levels and geographic areas in Sweden during 1990–2010; (2) identify prevalences of hypertension, awareness, treatment, and control in the population; and (3) assess the 10-year risk of developing hypertension among individuals with normal and high normal blood pressures.MethodsThis study is based on data from the Västerbotten Intervention Program (VIP) in Västerbotten County, Sweden. The cross-sectional analysis includes 133,082 VIP health examinations among individuals aged 30, 40, 50, and 60 years from 1990 to 2010. The panel analysis includes 34,868 individuals who were re-examined 10 years after the baseline examination. Individuals completed a self-administered health questionnaire that covers demographic and socio-economic information, self-reported health, and lifestyle behaviours. Blood pressure measurement was obtained prior to the questionnaire. In the cross-sectional analysis, trends of blood pressure by sex, and between educational groups and geographic areas are presented. In the panel analysis, the 10-year risk of developing hypertension is estimated using the predicted probability from logistic regression analysis for each sex, controlling for age and educational level.ResultsThe prevalence of hypertension decreased from 1990 to 2010; from 43.8 to 36.0% (p < 0.001) among men, and 37.6 to 27.5% among women (p < 0.001). Individuals with basic education had a significantly higher prevalence of hypertension compared to those with medium or high education. Although the decreases were observed in all geographic areas, individuals in rural inland areas had a much higher prevalence compared to those who lived in Umeå City. The proportion of hypertensive women who were aware of their hypertension (61.7%) was significantly higher than men (51.6%). About 34% of men and 42% of women with hypertension reported taking blood pressure medication. Over time, awareness and control of hypertension improved (from 46.5% in 1990 to 69% in 2010 and from 30 to 65%, respectively). The gaps between educational groups diminished. This study shows a significantly higher risk of developing hypertension for men and women with high normal blood pressure compared to those with normal blood pressure at baseline in all age cohorts and educational groups. The average risks of developing hypertension among men with high normal blood pressure were 21.5, 45.8, and 56.3% in the 30, 40, and 50-year cohorts, respectively. Corresponding numbers for women were 22.6, 47.4, and 57.9%.ConclusionsLevels of blood pressure and hypertension decreased significantly among the...

show abstract

Section: Discussionsupporting

confidence: 88%

Trends of blood pressure levels and management in Västerbotten County, Sweden, during 1990–2010

Carlberg

Weinehall

et al. 2012

Global Health Action

View full text Add to dashboard Cite

show abstract

“…In our survey as in many other studies [10,14-16,19-23] AH awareness and control were higher in women than in men, but the percentages of control indicate that women had a possibly better perception of hypertension-associated risks. In addition, some positive improvements in AH awareness, treatment and control were observed.…”

Section: Discussionsupporting

confidence: 69%

Trends in prevalence, awareness, treatment, and control of hypertension, and the risk of mortality among middle-aged Lithuanian urban population in 1983–2009

Rėklaitienė

Tamošiūnas

Virvičiūtė

et al. 2012

BMC Cardiovasc Disord

View full text Add to dashboard Cite

BackgroundArterial hypertension (AH) is a main risk factor for the risk from cardiovascular (CVD) and stroke mortality. Only few data was published on prevalence, awareness and management of AH in Lithuania. Development of objective approaches to the treatment and control of AH reduces the risk of mortality. The aim of this study was to evaluate time trends, the prevalence, awareness, treatment and control of AH and risk of mortality among Lithuanian urban population aged 45–64 years during the period of 1983–2009.MethodsTime trends of AH and risk of mortality were examined in three MONICA health surveys in 1983, 1986, 1992, and in one health survey according to MONICA protocol in 2002 included randomly recruited of 2,218 men and 2,491 women. AH was defined as systolic blood pressure (BP) ≥140 mmHg and/or diastolic BP of ≥90 mmHg or current use of antihypertensive medication. The main outcome measures were all-cause mortality, mortality from CVD, coronary heart disease (CHD) and stroke. The mean duration of follow-up was 11.8 ± 9.2 years. All survey periods were age standardized to the year 2006 of Kaunas population. The estimates of hazard ratio and 95% confidence interval were based on the multivariate Cox proportional hazards regression.ResultsIn men during 1983–2002 period hypertension prevalence was 52.1–58.7% and did not significantly change whereas in women decreased from 61.0 to 51.0%. There was a significant increase in hypertension awareness among hypertensive men and women (45.0 to 64.4% and 47.7 to 72.3%, respectively) and in treated hypertensives (55.4 to 68.3% in men and 65.6 to 86.2% in women). Adjusted Cox proportional hazard regression analyses revealed a strong dose–response association between blood-pressure level and all-cause, CVD, CHD and stroke-mortality risk in both men and women groups.ConclusionIn Lithuanian urban population the prevalence of hypertension remains high. Despite positive changes in hypertension awareness and treatment, hypertension control remains poor. A strong dose–response association between the level of BP and all-cause, CVD, CHD and stroke mortality risk was indicated.

show abstract

“…3 Population based studies have found that around two thirds of people with hypertension are either untreated or inadequately controlled, including many remain undiagnosed. [4][5][6] Many quantitative studies have published in knowledge, attitude and practice including adherence, whereas qualitative studies are subtle. The main aim of this study was to assess the knowledge of hypertensive patients about their disease in terms of causes, complications and barrier to get medications by in depth interview method.…”

mentioning

confidence: 99%

Lay perspectives on causes and complications of hypertension; and barrier to access health care by known hypertensive patients: a qualitative study from a rural area of South India

Newtonraj

Sugumaran

Bazroy

et al. 2017

Int J Community Med Public Health

View full text Add to dashboard Cite

Background: Global prevalence of hypertension in the year 2000 was estimated to be 26% with approximately 1 billion people affected by it. By 2025 this has been projected to increase to 29% increase to 29%, expecting greater proportion of population will be consists of elderly people. Limited qualitative studies on hypertension are available in India. We intended to conduct a qualitative study on the perception about hypertension causes, complications and barrier to get medications, among known hypertensive patients residing in rural area or south India.Methods: A qualitative study has been undertaken in August 2016 by the interns posted in Rural Health Training Centre of Pondicherry Institute of Medical Sciences (RHTC-PIMS). The study was completed after conducting in depth interview among 40 randomly selected known hypertensive patients. All the interviews were audio taped. Verbatim were done from the recording in local language (Tamil) and then translated to English. Coding and thematic analysis was done by analysis team consisting of one Assistant Professor in Community Medicine, one medical social worker (MSW) and three interns.Results: There is a huge lack of awareness about the causes of hypertension among the patients. There is also a huge lack of awareness about the complications of hypertension, among hypertensive patients. This may result in poor adherence to medication and prevention of complications. Almost all the patients reported that they were following Allopathic medications and getting medications from government primary health centre. There is a need to visit the health centre every week, as the medicines provided to them are only weekly basis.Conclusions: There is a huge lack of knowledge about hypertension among known hypertensive patients. There is a need for a holistic approach in managing hypertensive patients in rural area in India.

show abstract

Despite evidence-based guidelines, systolic blood pressure remains inadequately controlled in older hypertensive adults

Cited by 18 publications

References 43 publications

Trends of blood pressure levels and management in Västerbotten County, Sweden, during 1990–2010

Trends of blood pressure levels and management in Västerbotten County, Sweden, during 1990–2010

Trends in prevalence, awareness, treatment, and control of hypertension, and the risk of mortality among middle-aged Lithuanian urban population in 1983–2009

Lay perspectives on causes and complications of hypertension; and barrier to access health care by known hypertensive patients: a qualitative study from a rural area of South India

Contact Info

Product

Resources

About