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Longitudinal Trends in Hypertension Management and Mortality Among Octogenarians: Prospective Cohort Study
Alex Dregan1, Rathi Ravindrarajah2, Nisha Hazra2
1From the Department of Primary Care and Public Health (A.D., R.R., N.H., S.H., M.C.G.), National Institute for Health Research Biomedical Research Centre at Guy's and St. Thomas' National Health Service Foundation Trust (A.D., M.C.G.), and Department of Clinical Gerontology (S.H.D.J.), King's College London, London, United Kingdom. alexandru.dregan@kcl.ac.uk.
Hypertension (Dallas, Tex. : 1979)
|May 11, 2016
Summary
Hypertension management in octogenarians shows increasing awareness and treatment. Lower systolic blood pressure (<110 mmHg) is linked to higher mortality, not more stringent targets.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Public Health
Background:
- Hypertension management in octogenarians is debated.
- Long-term trends in hypertension among the elderly are not well-established.
Purpose of the Study:
- To assess trends in hypertension prevalence, awareness, treatment, and control in octogenarians.
- To evaluate the association between systolic blood pressure (SBP) levels and mortality in this age group.
Main Methods:
- Analysis of data from the English Longitudinal Study of Ageing (ELSA) (>10 years follow-up).
- Categorization of participants (n=2692) by SBP ranges.
- Assessment of hypertension prevalence, awareness, treatment, control, and mortality events.
Main Results:
- Mean SBP in octogenarians declined from 147 to 134 mmHg between 1998/2000 and 2012/2013.
- Hypertension prevalence and awareness were higher in octogenarians compared to younger adults (50-79 years).
- Higher all-cause mortality was observed at SBP <110 mmHg; lowest risk was seen at SBP 140-169 mmHg.
Conclusions:
- Hypertension awareness and treatment are increasing among community-dwelling octogenarians.
- Current findings do not support the notion that stricter blood pressure targets reduce mortality in this population.
- Lower SBP extremes (<110 mmHg) are associated with increased mortality risk.
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