Current situation of arterial hypertension in elderly people in Spain

Abstract

Our aim was to know the current situation of the Spanish elderly hypertensives trougouth a pooled analysis of the main epidemiological studies. Cardiovascular diseases supposed 52 % of all deaths in Spanish people over 65 years. From different cross-sectional studies we assume a prevalence of hypertension (BP≥140 and or 90 mmHg) of 61.4% (64,8% women and 58% men) and of Isolated Systolic Hypertension of 41,4% (43% women and 39.4% in men) among people over 65 years. Regarding their situation: 87% aware their hypertension and 72% are treated. Only 16.3% hypertensives are under control (BP < 140 ± 90 mmHg) but if we consider a BP ≤ 140/90 mmHg this rate increases to 30,1%. In relation to the ISH only 12% are controlled. Although 87,5% of the Spanish doctors consider a DBP < 90 mmHg as the target BP level for elderly hypertensives, only 23,3% agree with a SBP < 140 mmHg in people above 65 years. We found a high percentage of associated c-v risk factors and concomitant diseases (%): Obesity: 29,3%; Hypercholesterolemie: 26,2; Diabetes: 24,6; Smoking: 16,8; Stroke: 10,6; IHD: 33,9; CHF: 14,9; Arrythmias: 16,4; C Renal F: 19,5; Intermitent Claudication: 15,8; Osteoarthrosis: 37.6; Depression: 23, and Chronic Bronchitis: 12,4%. Use of antihypertensives (%): Diuretics: 31; BBs: 6,8; ACEIs: 39,5; CCBs: 28,5; Others groups: 4,2. 66% of the hypertensives were treated with monotherapie, 29 % with a variety of 2 drugs in combination and only 5% received three or more drugs. 85% of the patients declare different degrees of non-compliance with pharmacologic regimens. In conclusion, arterial hypertension remains as the more important c-v risk factor in the Spanish elderly population not only due to its high prevalence and insufficient degree of control, but also because of the quite common clustering with other cardiovascular risk factors. ACE inhibitors and diuretics are the more used antihypertensive drugs. Although a high percentage of the hypertensives are treated, we need to implement their control by using more adequate therapeutic strategies and improving the patient's compliance.