Prevalence, awareness, treatment, and control of hypertension in older people: results from the population-based KORA-age 1 study

Abstract

Background: Hypertension remains a significant modifiable risk factor for cardiovascular diseases and a major determinant of morbidity and mortality. We aimed to describe sex-stratified age-standardized estimates of prevalence, awareness, treatment and control of hypertension, and their associated factors in older adults. Methods: The KORA-Age1 is a population-based cross-sectional survey carried out in 2008/2009 on individuals aged 65-94 years in Augsburg region, Germany. Blood pressure measurements were available for 1052 out of 1079 persons who participated in the physical examination. Factors associated with prevalence, awareness and control of hypertension were investigated by multivariable logistic regression. Results: The overall prevalence of hypertension (≥140/90 mmHg) was 73.8% [95% confidence interval (CI), 69.3-77.9], representing 74.8% (95% CI, 68.4-80.2) in men and 73.5% (95% CI, 66.8-79.3) in women. Among those with hypertension, 80.2% (95% CI, 75.3-84.4) were aware of their hypertensive condition and 74.4% (95% CI, 69.2-79.1) were on treatment for hypertension. Among those aware of their hypertension status, 92.8% (95% CI, 88.8-95.6) were on treatment and 53.7% (95% CI, 47.0-60.1) had their blood pressure controlled. Hypertension was more frequent in individuals who were older, obese, or had diabetes. Higher education attainment or presence of comorbidities was associated with higher level of hypertension awareness. Individuals taking three antihypertensive drug classes were more likely to have controlled hypertension compared with those taking one antihypertensive drug class, odds ratio (OR), 1.85 (95% CI, 1.14-2.99). Conclusion: Our findings identified high prevalence of hypertension and relevant health gaps on awareness, treatment and suboptimal control of hypertension in older adults in Germany. Screening for hypertension should especially target older adults with low educational attainment and 'healthy' elderly with less contact to physicians.

Factors associated with treatment and control of hypertension among elderly adults in Shenzhen, China: a large-scale cross-sectional study

“…21 Even so, the treatment rate of hypertension in the elderly population in Shenzhen was still far below that of elderly in other countries such as the USA, Australia, Germany and Colombia. [22][23][24] Similar to other studies, we found that the treatment of hypertension was significantly higher among older, ex-smokers, non-drinkers,higher education level and those engaging in physical activity. 9 19 24 25 Participants engaged in physical activity may generally pay more attention to their health.…”

“…Our study revealed a higher level of treatment in individuals with comorbidities such as overweight, obesity, central obesity, diabetes and dyslipidaemia, which are common comorbidities with hypertension. 19 23 Moreover, in our study, history of CVD was highly correlated with receiving antihypertensive treatment. Other researchers have confirmed that having another medical condition, for example, diabetes or dyslipidaemia, is associated with greater awareness and treatment of hypertension.…”

Real-World Hypertension Prevalence, Awareness, Treatment, and Control in Adult Diabetic Individuals: An Italian Nationwide Epidemiological Survey

“…Hypertension control rates among NHANES nondiabetic individuals (39.01%, 95% CI 33.68-44.60) were comparable to our findings, and not dissimilar than those of NHANES diabetic individuals (40.39%, 95% CI 33.96-47.17) [24]. Another population-based cross-sectional survey found that treated hypertensives with diabetes were less likely to have controlled BP (OR 0.38, 95% CI 0.25-0.58) compared with nondiabetics [25]. Altogether, real-world data indicate that attaining BP treatment goal remains a major challenge, especially when multiple cardiovascular risk factors coexist.…”

Awareness, Treatment, and Control of Hypertension Among 10663 Adults in Kherameh: A Population-Based Study

“…Having other chronic diseases was associated with higher awareness and better control, too. In one study, people with diabetes, obesity, heart disease, and stroke were more likely to see a doctor and have their BP checked (26). In the present study, the patients who had a history of cardiovascular disease in their rst-and second-degree relatives had higher awareness and better control.…”

“…Similar results were also obtained in a survey performed on the people aged 65-94 years in Germany. In that study, 80.2% of the patients knew that they had HTN and 74.4% of the patients and 92.8% of the informed individuals took antihypertensive drugs (26). The higher awareness in the present study might result from a better access to health care.…”