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Pharmacotherapy and blood pressure control in elderly hypertensives in a primary care setting in Bahrain

Khalid A Jassim Al Khaja1, Reginald P Sequeira, Awatif H H Damanhori

  • 1Department of Pharmacology and Therapeutics, College of Medicine and Medical Sciences, Arabian Gulf University, Kingdom of Bahrain. khlidj@agu.edu.bh

Aging Clinical and Experimental Research
|December 4, 2004
PubMed

Insights

Optimal blood pressure control in elderly hypertensives remains a challenge, with few achieving guideline targets. Physician adherence to hypertension management guidelines in primary care requires improvement for better patient outcomes.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Background:

  • Antihypertensive treatment in the elderly significantly reduces cardiovascular risks.
  • Current primary care practices in Bahrain were evaluated for adherence to hypertension management guidelines.

Purpose of the Study:

  • To assess primary care physician adherence to World Health Organization/International Society of Hypertension (WHO/ISH) guidelines for antihypertensive drug management in elderly patients.
  • To determine the extent of blood pressure (BP) control achieved in this population.

Main Methods:

  • A multicentric therapeutic audit of medical records was conducted.
  • Data from elderly hypertensive patients (>= 60 years) in nine primary care centers in Bahrain were analyzed.

Main Results:

  • Only 11.1% of elderly hypertensives and 4.1% of elderly diabetic hypertensives met WHO/ISH-1999 BP targets (<140/90 mmHg or <130/85 mmHg for diabetics).
  • Combination therapy was used in about half of patients, with no significant BP difference compared to monotherapy.
  • Beta-blockers were most prescribed overall, ACE inhibitors in diabetics, while preferred diuretics and calcium channel blockers were underutilized, especially in isolated systolic hypertension.

Conclusions:

  • Suboptimal drug management and poor adherence to guidelines were observed in elderly hypertensive patients.
  • Comorbidities like diabetes influenced antihypertensive choices, but overall therapy tailoring was inadequate.
  • Improved drug management strategies are needed in primary care for elderly hypertensive patients.
Abstract

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