4.7 Article

Adequacy of control of hypertension ion an academic nursing home

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ELSEVIER SCIENCE INC
DOI: 10.1016/j.jamda.2007.06.012

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antihypertensive drugs; hypertension; elderly

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Objective: To determine the prevalence of hypertension, of adequate control of hypertension, of number of anti hypertensive drugs used to treat hypertension, and of types of anti hypertensive drugs used to treat hypertension in older persons who were not terminally ill in an academic nursing home. Design: Hypertension was diagnosed if the systolic blood pressure was 140 mm Hg or higher and 130 mm Hg or higher if the person had diabetes or chronic renal insufficiency or if the diastolic blood pressure was 90 mm Hg or higher and 80 mm Hg or higher if the person had diabetes or chronic renal insufficiency. Hypertension was adequately controlled if the blood pressure was lower than 140/90 mm Hg and lower than 130/80 mm Hg if the person had diabetes or chronic renal insufficiency. Setting: An academic nursing home. Participants: Two hundred and two persons (104 women and 98 men), mean age 73 years (range 50 to 98 years) residing in an academic nursing home. Measurements: Prevalence of hypertension, of adequate control of hypertension, of number of antihypertensive drugs used, and of types of antihypertensive drugs used. Results: Hypertension was present in 143 (71 %) of 202 persons. Adequate hypertension control was present in 121 (85%) of 143 persons with hypertension. Of 143 persons treated with anti hypertensive drugs, 39 (27%) received 1 anti hypertensive drug, 61 (43%) received 2 antihypertensive drugs, 31 (22%) received 3 antihypertensive drugs, 8 (6%) received 4 anti hypertensive drugs, and 4 (3%) received 5 anti hypertensive drugs. Of 143 persons treated with anti hypertensive drugs, 107 (75%) received beta blockers, 88 (62%) received angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, 49 (34%) received diuretics, 41 (29%) received calcium channel blockers, 15 (10%) received clonidine, and 6 (4%) received hydralazine. Conclusion: The prevalence of hypertension in older persons in an academic nursing home was 71 %, and 85% of these persons had adequate control of hypertension.

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