Prevalence of Comorbidities and Their Influence on Blood Pressure Goal Attainment in Geriatric Patients

Bisognano, John D.; Townsend, Kevin; Skyles, Amy J.; Samuels, Kiela

doi:10.1111/j.1076-7460.2007.05543.x

Cited by 12 publications

(10 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The identification of these predictors is consistent with the findings of previous studies. Having heart failure is consistent with a previous study of elderly hypertensive patients with multiple comorbidities . However, a study by Shelley et al.…”

Section: Discussionsupporting

confidence: 92%

“…In the adjusted model, diabetes, ABI < 0.09 in either leg at rest and being aged over 65 years had significant impact on LTB. This reflects a general under‐appreciation of comorbidities in patients with atherothrombotic disease and highlights the importance of achieving BP targets with blood pressure medication . The findings of this study confirm the findings of previous studies, which indicate that blood pressure control is difficult to achieve in older persons .…”

Section: Discussionsupporting

confidence: 82%

See 1 more Smart Citation

The Impact of Lost Therapeutic Benefit (LTB) in High‐Risk Hypertensive Patients: 2‐Year Follow‐Up Data from the Australian REACH Registry

Ademi

Huq

Liew

et al. 2013

Cardiovascular Therapeutics

View full text Add to dashboard Cite

SUMMARYObjective: The aim of the study is to determine the extent of lost therapeutic benefit (LTB) in the hypertensive patients, and to determine the relationship between the presence of LTB and clinical outcomes. Methods: Prospective-cohort study of n = 2856 patients with or at high risk of atherothrombosis. LTB was calculated as the proportion of patients receiving blood pressure medication who were not attaining guideline blood pressure (BP) control targets (<140/90 mmHg). Logistic regression analysis was performed to identify predictors of LTB at baseline, and propensity score matching (PSM) was undertaken to estimate the treatment effects by matching case LTB and control non-LTB cohorts based on the nearest neighbor matching. Results: Of the total sample of 2856, 45.6% had uncontrolled BP, and LTB was present in 46. . Following PSM, the combination of ischemic events (55-64 age category) was more likely to occur in the LTB compared with non-LTB group (4.38% and 0.68%, respectively [P = 0.046]). Conclusion: Presence of HF, previous MI and being male decreased the likelihood of LTB, while presence of diabetes, age > 65 and ABI < 0.09 increased the risk of LTB. Patients with LTB in age category 55-64 had higher incidence of vascular events compared with those with non-LTB.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 82%

The Impact of Lost Therapeutic Benefit (LTB) in High‐Risk Hypertensive Patients: 2‐Year Follow‐Up Data from the Australian REACH Registry

Ademi

Huq

Liew

et al. 2013

Cardiovascular Therapeutics

View full text Add to dashboard Cite

show abstract

“…17 The overall comorbidity rate of 76% aligned with epidemiological surveys, where at least two thirds of hypertensive patients suffered from comorbidities. 18 , 19 The prevalence of specific comorbidities such as diabetes and dyslipidemia was comparable with that of a larger survey in a Western population. 20 Therefore, our data may be considered representative for Switzerland with regard to demographics and as typical with regard to comorbidities in hypertensive patients.…”

Section: Discussionsupporting

confidence: 53%

Antihypertensive combination therapy in primary care offices: results of a cross-sectional survey in Switzerland

Roas

Bernhart²,

Schwarz³

et al. 2014

IJGM

View full text Add to dashboard Cite

BackgroundMost hypertensive patients need more than one substance to reach their target blood pressure (BP). Several clinical studies indicate the high efficacy of antihypertensive combinations, and recent guidelines recommend them in some situations even as initial therapies. In general practice they seem widespread, but only limited data are available on their effectiveness under the conditions of everyday life. The objectives of this survey among Swiss primary care physicians treating hypertensive patients were: to know the frequency of application of different treatment modalities (monotherapies, free individual combinations, single-pill combinations); to see whether there are relationships between prescribed treatment modalities and patient characteristics, especially age, treatment duration, and comorbidities; and to determine the response rate (percentage of patients reaching target BP) of different treatment modalities under the conditions of daily practice.MethodsThis cross-sectional, observational survey among 228 randomly chosen Swiss primary care physicians analyzed data for 3,888 consecutive hypertensive patients collected at one single consultation.ResultsIn this survey, 31.9% of patients received monotherapy, 41.2% two substances, 20.9% three substances, and 4.7% more than three substances. By combination mode, 34.9% took free individual combinations and 30.0% took fixed-dose single-pill combinations. Combinations were more frequently given to older patients with a long history of hypertension and/or comorbidities. In total, 67.8% of patients achieved their BP target according to their physician’s judgment. When compared, single-pill combinations were associated with a higher percentage of patients achieving target BP than free individual combinations and monotherapies for the total sample and for patients with comorbidity.ConclusionAntihypertensive combination therapy was widely used in Swiss primary care practices. The number of prescribed substances depended on age, treatment duration, and type and number of comorbidities. Although the response rate was generally modest under the conditions of daily practice, it was higher for single-pill combinations than for monotherapies and free individual combinations. Further studies are needed to confirm these observations.

show abstract

“…1 This is especially true for older adults, 4,7 who often present with comorbidities. 8 In NYC, adults aged 65 and older, control among those being treated is only 57%, compared with 72% for those younger than 65. 3 Health behavior models illustrate why hypertension and other chronic diseases cannot be controlled solely through the clinician-patient relationship.…”

mentioning

confidence: 99%

“…Visits, mean (range): 4.7(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) Months observed, mean ±SD= 3.8 ±1.Flow of Keep on Track program and participants from implementation to evaluation.…”

mentioning

confidence: 99%

Keep on Track: A Volunteer‐Run Community‐Based Intervention to Lower Blood Pressure in Older Adults

Truncali

Dumanovsky²,

Stollman

et al. 2010

J American Geriatrics Society

View full text Add to dashboard Cite

Uncontrolled hypertension in older adults is a common yet preventable threat to healthy aging. Improvements in blood pressure (BP) control and related health outcomes require innovative approaches that reach beyond the clinical environment. Keep on Track (KOT), a volunteer-run, community-based BP-monitoring program that aims to lower BP of community-dwelling older adults through senior center programming, is described and evaluated. KOT is based on a New York City (NYC) Department for the Aging program that has been in existence for more than 20 years and is evaluated in six senior centers in low- to middle-income neighborhoods in NYC. Program design includes monitoring sessions every other week to measure and record participant BP. BP education is provided using low-literacy materials, and medication adherence is encouraged. Over 6 months of observation, 244 participants enrolled (mean age 73). Of the 181 (74%) with hypertension at baseline, 92% were previously aware of their condition, 78% were treated, and 31% were controlled. BP control among the treated was 42%. Forty-three percent of enrollees (n=105) were multiple-visit participants who experienced on average a 3.9-mmHg reduction in systolic BP (SBP) between the first and last program visit (95% confidence interval (CI)=-7.6 to -0.1, P=.04). Participants with an initial SBP greater than 160 mmHg (n=20) experienced on average a 20.9-mmHg reduction in SBP (95% CI=-32.4 to -9.4, P<.001). Areas for program improvement include greater attention to peer counseling and timely communication with participants' healthcare providers. Volunteer-run, community-based BP monitoring in senior centers may provide an effective, replicable model for reducing BP in older adults.

show abstract

Prevalence of Comorbidities and Their Influence on Blood Pressure Goal Attainment in Geriatric Patients

Cited by 12 publications

References 25 publications

The Impact of Lost Therapeutic Benefit (LTB) in High‐Risk Hypertensive Patients: 2‐Year Follow‐Up Data from the Australian REACH Registry

The Impact of Lost Therapeutic Benefit (LTB) in High‐Risk Hypertensive Patients: 2‐Year Follow‐Up Data from the Australian REACH Registry

Antihypertensive combination therapy in primary care offices: results of a cross-sectional survey in Switzerland

Keep on Track: A Volunteer‐Run Community‐Based Intervention to Lower Blood Pressure in Older Adults

Contact Info

Product

Resources

About