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Prevalence, prescribing and barriers to effective management of hypertension in older populations: a narrative review.

Alhawassi TM, Krass I, Pont LG - J Pharm Policy Pract (2015)

Bottom Line: A review of English language studies published prior to 2013 in Medline, Embase and Google scholar was conducted.System, physician and patient related barriers to optimal blood pressure control were identified.Concerns regarding adverse effects appearcentral to under treatment of hypertension among older populations.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Pharmacy, University of Sydney, Sydney, Australia ; College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.

ABSTRACT

Objectives: Hypertension is the leading modifiable cause of mortality worldwide. Unlike many conditions where limited evidence exists for management of older individuals, multiple large, robust trials have provided a solid evidence-base regarding the management of hypertension in older adults. Understanding the impact of age on how the prevalence of hypertension and the role of pharmacotherapy in managing hypertension among older persons is a critical element is the provision of optimal health care for older populations. The aim of this study was to explore how the prevalence of hypertension changes with age, the evidence regarding pharmacological management in older adults and to identify known barriers to the optimal management of hypertension in older patients.

Methods: A review of English language studies published prior to 2013 in Medline, Embase and Google scholar was conducted. Key search terms included hypertension, pharmacotherapy, and aged.

Results: The prevalence of hypertension was shown to increase with age, however there is good evidence for the use of a number of pharmacological agents to control blood pressure in older populations. System, physician and patient related barriers to optimal blood pressure control were identified.

Conclusions: Despite good evidence for pharmacological management of hypertension among olderpopulations, under treatment of hypertension is an issue. Concerns regarding adverse effects appearcentral to under treatment of hypertension among older populations.

No MeSH data available.


Related in: MedlinePlus

Increasing prevalence of hypertension with age
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Fig1: Increasing prevalence of hypertension with age

Mentions: Data from the Framingham study in 1978 and 2002 [12–14] and the 2005 US National Health and Nutrition Survey (NHANES) [15] have shown clear increases in the prevalence of hypertension with age (Fig. 1). The original Framingham study followed 5209 respondents from 1948 until 2005, exploring the development of cardiovascular disease and identification of associated risk factors over time [2, 3]. The NHANES surveys are annual cross sectional surveys which combine interview and physical examination, to assess health status across representative samples of the American population.[15] The NHANES data demonstrated that increases in the prevalence of hypertension prevalence begin in adulthood, with the prevalence doubling between the ages of 20–40 years, and then with a further 100 % increase occurring between 40 and 60 years. The Framingham study showed that this pattern continues as people age, with the prevalence of hypertension increasing from 27.3 % in those aged ≥ 60 years to 74.0 % in those aged over 80 years.Fig. 1


Prevalence, prescribing and barriers to effective management of hypertension in older populations: a narrative review.

Alhawassi TM, Krass I, Pont LG - J Pharm Policy Pract (2015)

Increasing prevalence of hypertension with age
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4607150&req=5

Fig1: Increasing prevalence of hypertension with age
Mentions: Data from the Framingham study in 1978 and 2002 [12–14] and the 2005 US National Health and Nutrition Survey (NHANES) [15] have shown clear increases in the prevalence of hypertension with age (Fig. 1). The original Framingham study followed 5209 respondents from 1948 until 2005, exploring the development of cardiovascular disease and identification of associated risk factors over time [2, 3]. The NHANES surveys are annual cross sectional surveys which combine interview and physical examination, to assess health status across representative samples of the American population.[15] The NHANES data demonstrated that increases in the prevalence of hypertension prevalence begin in adulthood, with the prevalence doubling between the ages of 20–40 years, and then with a further 100 % increase occurring between 40 and 60 years. The Framingham study showed that this pattern continues as people age, with the prevalence of hypertension increasing from 27.3 % in those aged ≥ 60 years to 74.0 % in those aged over 80 years.Fig. 1

Bottom Line: A review of English language studies published prior to 2013 in Medline, Embase and Google scholar was conducted.System, physician and patient related barriers to optimal blood pressure control were identified.Concerns regarding adverse effects appearcentral to under treatment of hypertension among older populations.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Pharmacy, University of Sydney, Sydney, Australia ; College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.

ABSTRACT

Objectives: Hypertension is the leading modifiable cause of mortality worldwide. Unlike many conditions where limited evidence exists for management of older individuals, multiple large, robust trials have provided a solid evidence-base regarding the management of hypertension in older adults. Understanding the impact of age on how the prevalence of hypertension and the role of pharmacotherapy in managing hypertension among older persons is a critical element is the provision of optimal health care for older populations. The aim of this study was to explore how the prevalence of hypertension changes with age, the evidence regarding pharmacological management in older adults and to identify known barriers to the optimal management of hypertension in older patients.

Methods: A review of English language studies published prior to 2013 in Medline, Embase and Google scholar was conducted. Key search terms included hypertension, pharmacotherapy, and aged.

Results: The prevalence of hypertension was shown to increase with age, however there is good evidence for the use of a number of pharmacological agents to control blood pressure in older populations. System, physician and patient related barriers to optimal blood pressure control were identified.

Conclusions: Despite good evidence for pharmacological management of hypertension among olderpopulations, under treatment of hypertension is an issue. Concerns regarding adverse effects appearcentral to under treatment of hypertension among older populations.

No MeSH data available.


Related in: MedlinePlus