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[Arterial hypertension as a medical and social problem in the older urban population. The CINDI WHO Program study]
Krystyna Kaczmarczyk-Chałas1, Magdalena Kwaśniewska, Małgorzata Pikala
1Zakład Medycyny Zapobiegawczej, Katedra Medycyny Społecznej i Zapobiegawczej, Uniwersytet Medyczny w Łodzi. office@cindi.org.pl
Insights
Arterial hypertension is common in Polish seniors, with many undertreated. Effective blood pressure control remains a challenge, highlighting the need for better management strategies in the elderly population.
Area of Science:
- Gerontology
- Cardiology
- Public Health
Background:
- The aging Polish population presents increasing healthcare demands, with chronic diseases like arterial hypertension being highly prevalent among seniors.
- Arterial hypertension (HA) is a leading cause of morbidity in the elderly, necessitating a thorough understanding of its characteristics and management.
Purpose of the Study:
- To characterize hypertension in the elderly Polish population.
- To analyze associated risk factors, complications, and therapeutic control of arterial hypertension in seniors.
- To provide insights for improving healthcare strategies for elderly individuals with hypertension.
Main Methods:
- A cross-sectional study conducted in 2002 in Lodz, Poland, as part of the CINDI WHO Programme.
- Random sampling of 1460 residents aged 65 years and older, with a response rate of 57%.
- Data collection included questionnaire interviews, blood pressure measurements, anthropometric and physical examinations, ECG, and laboratory tests from 828 participants.
Main Results:
- The prevalence of hypertension was high (79% in men, 82% in women), with a mean systolic BP of 147.6 mmHg and diastolic BP of 83.6 mmHg.
- Only 28% of treated hypertensive patients achieved normalized blood pressure (<140/90 mmHg).
- Hypertensive seniors exhibited higher rates of obesity, visceral obesity, metabolic syndrome, and cardiovascular events, and utilized healthcare services more frequently.
Conclusions:
- Arterial hypertension is highly prevalent and inadequately controlled in the elderly Polish population.
- Hypertension in seniors is associated with significant cardiovascular risks and increased healthcare utilization.
- Improved management and therapeutic control strategies are crucial for this demographic.
Abstract:
Increasing lifespan and progressive aging of the Polish population results in rising demands on health care. Chronic diseases with a leading position of arterial hypertension (HA) prevail in morbidity rates of adult seniors. The aim of the study is to characterize hypertension in the elderly with regard to other risk factors, complications and therapeutic control. The study was carried out in 2002 within the framework of the CINDI WHO Programme. A total of 1460 persons were randomly selected among residents of Lodz aged > or = 65 years. The response rate was 57%. All participants underwent questionnaire interview, two blood pressure (BP) measurements, anthropometric and physical examination, ECG and laboratory tests. After final verification, we analysed data collected from 828 persons (289 men and 539 women). Mean values of systolic and diastolic BP were 147.6 and 83.6 mmHg, respectively. The increase of systolic BP with age of studied seniors was observed. Hypertension was diagnosed in 669 persons (79% men, 82% women). In most cases there were systolic-diastolic or isolated systolic hypertension. About 60% of seniors with elevated BP declared suffering from HA, while 73% were under antihypertensive treatment. Normalization of BP (< 140/ 90 mmHg) was achieved in 28% of treated patients. Most often prescribed medications were: ACE-inhibitors (51%), beta-blockers (40%), calcium channel blockers (31%) and diuretics (30%). Mean values of plasma lipids and prevalence of lipid disorders were comparable in hypertensive and normotensive persons. Among patients with HA there were significantly smaller percentage of smokers (8.6% vs 18.7%, p < 0.05). The prevalence of obesity, visceral obesity and metabolic syndrome was higher in hypertensive seniors. As a result, incidents of myocardial infarction and morbidity due to coronary artery disease were twice as cantly more often hospitalised and visited family doctors (7 vs 4.6 visits/year) in comparison to normotensive subjects.
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