Abstract 636: Factors Impacting Blood Pressure Control in the Elderly and very Elderly Hypertensive Patients After 8 Weeks Valsartan/Amlodipine SPC Treatment: CHINA STATUS II Subgroup Analysis

Abstract

Objective: To determine the factors that impact BP control in Chinese elderly (aged 65-79 years) and very elderly (aged ≥80 years) hypertensive patients after 8-week treatment with val/aml SPC in the CSII study. Design and Methods: 3609 elderly and very elderly hypertensive patients uncontrolled by monotherapy with BP ≥140/90 mm Hg (≥130/80 mm Hg for diabetes or CKD) were analyzed. It was a post-hoc analysis of subgroups from the CSII study. All patients received val/aml 80/5 mg SPC for 8 weeks. An additional antihypertensive agent added in patients who were still uncontrolled at the end of 4 weeks. Complications, previous antihypertensive treatment and demographic factors were recorded. Chi-square test, Student’s t-test and logistic regression analysis were conducted. Results: After 8 weeks treatment, 61.5% elderly (n=459) and 63.3% very elderly (n=1811) patients achieved BP control. In the 740 elderly patients, low BP control rates were observed in patients with coronary heart disease (CHD) [P <0.05 vs without CHD]. Significant decrease of BP control rates also were observed in 620 elderly type 2 diabetes mellitus (DM) patients (P<0.0001 vs. non-diabetics) and 89 elderly heart failure (HF) patients (P<0.05, vs without HF) while stroke had no effect(P>0.05). Previous antihypertensive treatment (ACEI, ARB, CCB, βblocker and diuretic) had no significant influence on BP control (P>0.05 ) . Among cardiovascular risk factors , while dyslipidemia influenced the BP control rate(P<0.05); patient’s sex, BMI, smoking and alcohol consumption had no effect(P>0.05). In very elderly patients, DM led to low BP control (P<0.0001), but there was no significant impact of CHD, HF and stroke. Previous antihypertensive drugs did not influence the BP control rate (P>0.05), but alcohol consumption had a significant impact (P<0.05). Conclusion: CHD, DM, HF and dyslipidemia negatively influenced BP control in the elderly patients. In the very elderly patients, diabetes and history of alcohol consumption were associated with low BP control rates. The effect of the above risk factors on BP control should be considered during the management of hypertension in the elderly and very elderly Chinese patients with above complications as they would need stricter BP control.