1. Evaluation of systolic blood pressure control in elderly patients with isolated systolic hypertension.
- Author
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Pannarale G, Licitra R, Leonetti S, Arrivi A, Corsi F, Gianturco L, Mirabelli F, Acconcia MC, and Gaudio C
- Subjects
- Aged, Antihypertensive Agents pharmacology, Community Medicine, Cross-Sectional Studies, Dihydropyridines pharmacology, Dihydropyridines therapeutic use, Drug Utilization, Electrocardiography, Female, Humans, Hypertension diagnosis, Male, Practice Guidelines as Topic, Practice Patterns, Physicians', Retrospective Studies, Rome, Sodium Chloride Symporter Inhibitors pharmacology, Sodium Chloride Symporter Inhibitors therapeutic use, Antihypertensive Agents therapeutic use, Blood Pressure drug effects, Health Services for the Aged, Hypertension drug therapy
- Abstract
The aim of this retrospective study was the evaluation of systolic blood pressure (SBP) control in elderly patients (pts) with isolated systolic hypertension (ISH). We assessed SBP control (i.e. average of 2 clinic BP measurements < 140 mmHg) in 152 pts (44 M, 108 F, 75 +/- 6 years) with ISH (149/84 +/- 17/6 mmHg), treated for at least 3 months by general practitioners or specialists with treatments of their choice. Most antihypertensive drugs were used at starting doses in monotherapy or combination treatment, as usual in clinical practice. ECG was abnormal in 82/152 pts (54.0%). All pts were divided in 2 groups according to SBP control. The 2 groups were compared by chi-square test for categorical variables and by Mann-Whitney test for quantitative variables. A p value < 0.05 was considered statistically significant. The global SBP control rate was 41.4% (63/152 pts). BP was higher in pts with poor SBP control, as expected, but the 2 groups were similar for sex distribution, age, prevalence of other cardiovascular risk factors and type of care (general practitioner or specialist). Pts with poor SBP control had a higher prevalence of abnormal ECG tracings (p = 0.003), a lower prevalence of combination regimes (p = 0.007) and prescriptions of dihydropyridine calcium antagonists or thiazide diuretics (p = 0.006). Global SBP control rate in our retrospective study in pts with ISH was unsatisfactory. Use of dihydropyridines or thiazides, drugs of choice in the management of ISH according to ESH/ESC and JNCVII guidelines, as single drugs or in combination regimes, can improve BP control and prevent cardiac damage.
- Published
- 2006