[Differences in the degree of control of arterial hypertension according to the measurement procedure of blood pressure in patients ≥ 65 years. FAPRES study]

Abstract

Background and objectives: Control of arterial blood pressure (BP) in hypertensive patients differs based on the evaluation procedure. This fact can be enhanced in subjects over 65 years of age. We have studied the degree of BP control with determinations in the office or ambulatory blood pressure monitoring (ABPM).

Methods: A multicenter, cross-sectional study was conducted in primary care (PC) and hypertension units in the Valencian Community. The first three hypertensive patients ≥ 65 years who attended the consultation on the first day of visits of the week of each investigator were included in the study. Cardiovascular risk factors, target organ damage and associated cardiovascular disease were recorded. Good clinical control values were defined as < 140/90 in the office and < 130/80 by ABPM for 24-hour according to 2007 ESH/ESC guidelines.

Results: A total of 1,028 hypertensive patients were included, 52.7% of whom were women, with a mean age of 72.6 years. Mean clinical BP was 146.7/81.1 mmHg and 24-hour ABPM 128.5/70.8 mmHg. Ninety-two percent of the patients were treated with antihypertensive drugs (35.6% monotherapy and 56.4% with combinations of two or more drugs). Good clinical control was found in 35.3% of cases (CI 95%: 32.4-38.2) and 50.9% (CI 95%: 47.8-54.0) (P < .001) had good control of 24-hour BP in ABPM. Male gender, personal background of heart disease and stroke were associated with good control of hypertension (P < .01) in 24-hour ABPM.

Conclusions: In hypertensive patients over 65 years, and compared to the clinical determination of BP, the evaluation of ABMP showed a better proportion of controlled subjects. These findings support a wider use of ABPM to evaluate the control of BP in this population.