Abstract 4903: Control of Hypertension in All Age Groups in a Large Multiyear Multicenter Analysis From the Department of Veterans Affairs
Introduction: Benefits of blood pressure (BP) control have been well elucidated, but overall BP control remains poor. Elderly patients are considered resistant or difficult to control. Thus, we assessed the effect of organized interventions to control blood pressure in a large cohort of patients in the Department of Veteran Affairs.
Methods: From January of 2000 to December 2007, we assessed BP control in 478,099 patients from 15 VA hospitals in various geographic locations around the United States. Patients were divided in 4 groups based on age: G1 <55 (N = 105,119), G2 55- <70 (N = 174,418), G3 70- <80 (N = 129,516), G4 ≥ 80 (N = 69,046). Medical interventions to control BP included use of electronic medical records with automated reminders, medical regimen adjustments, and frequent visits to both specialty and nurse run clinics.
Results: Control rates (BP ≤ 140/90) at baseline were: 49.5% in G1, 43.6% in G2, 43.5% in G3 and 44.0% in G4. After 7 years of follow up BP control improved to 69.9% in G1, 70.9% in G2, 72.3% in G3 and 71.6% in G4 (p <0.0001 for all groups compared to baseline). Average blood pressure changes are shown (figure⇓). Patients over the age of 70 achieved the greatest systolic BP reduction. Diastolic BP decreased in all age groups over the age of 55, but remained unchanged in the younger age group. BP levels were lower during the summer time as compared to winter in all age groups.
High rates of BP control can be achieved even among the very old.
Older patients respond well to appropriate interventions.
Diastolic BP decreased in all age groups over the age of 55, but remained unchanged in younger patients.
Seasonal BP variation is seen independent of age.