Abstract 18440: Hypertension Control in all Age Groups - a VA 10 Year Multicenter Analysis
Introduction: While the benefits of blood pressure (BP) control are well known, BP control is rarely studied in large populations. Elderly patients have been considered difficult to control. We reviewed blood pressure control in a large cohort of VA patients.
Methods: From September 2000 to August 2010, we assessed BP control in 582,851 hypertensive 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=176,604), G2: 55 - <70 (N=214,967), G3: 70 - <80 (N=139,103), G4: >80 (N=52,177). 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) in FY00 were: 50.0% in G1, 45.5% in G2, 45.5% in G3 and 47.8% in G4. After 10 years of follow up, BP control improved to 73.6% in G1, 74.5% in G2, 75.1% in G3 and 73.2% in G4 (p<0.0001 for all groups compared to baseline). In all age groups, BP levels were lower during summer as compared to winter. Diastolic BP for patients over the age of 55 approached that of those < 55. Systolic and diastolic BP fell more rapidly in the first 6 years than the last 4 years. The stable diastolic BP achieved in the last 4 years permits BP control without deleterious low levels of diastolic BP in elderly patients.
Conclusions: 1) All age groups can be well controlled, with lower rates of control in average systolic and diastolic BP in the last 4 years. 2) Older patients > 70 yo respond well and achieve higher control rates without deleterious lowering of diastolic BP. 3) Seasonal BP variation is seen independent of age.
- © 2011 by American Heart Association, Inc.