Abstract
Background: Among Chinese adults aged 35 - 75 years, nearly half have hypertension and the prevalence of hypertension is increased with age. But older patients with high systolic pressure and high pulse pressure could not be cured, and will have greater cardiovascular morbidity. This study aims to evaluate the effectiveness of general practitioners (GP) management for Chinese elderly hypertension, and explore reasonable and effective blood pressure management pattern. Methods: We searched the published literature for randomized controlled trials designed to improve blood pressure with community care management delivered by general practitioners or nurses, compared with usual care. Major outcome measures were systolic and diastolic blood pressure; the percentage of patients whose blood pressures are under control with community care management and Revman 5.3 was used in this study. Results: Pooled data from all 13 researches showed a lower outcome diastolic blood pressure (SMD = −0.95, 95% CI (−1.23, −0.67)) and systolic blood pressure (SMD = −1.17, 95% CI (−1.52, −0.81)) respectively in favor of community management. Pooled data from all 11 researches showed a higher percentage of patients with blood pressure under control in favor of community management (OR = 3.85, 95% CI (1.58, 9.37)) and the difference between treatment group and control group on blood pressure control ratio had statistical significance (Z = 2.97, P < 0.01). No obvious difference was found among the sub-groups. Conclusions: General practitioners’ management in Chinese elderly hypertension is effective, and complies with the advanced hypertension management guidelines. The multi-patterns are supposed to adopt community blood pressure monitoring and team-based general practitioners.
Highlights
Among Chinese adults aged 35 - 75 years, nearly half have hypertension and the prevalence of hypertension is increased with age
This study aims to evaluate the effectiveness of general practitioners (GP) management for Chinese elderly hypertension, and explore reasonable and effective blood pressure management pattern
Major outcome measures were systolic and diastolic blood pressure; the percentage of patients whose blood pressures are under control with community care management and Revman 5.3 was used in this study
Summary
Among Chinese adults aged 35 - 75 years, nearly half have hypertension and the prevalence of hypertension is increased with age. Major outcome measures were systolic and diastolic blood pressure; the percentage of patients whose blood pressures are under control with community care management and Revman 5.3 was used in this study. Results: Pooled data from all 13 researches showed a lower outcome diastolic blood pressure (SMD = −0.95, 95% CI (−1.23, −0.67)) and systolic blood pressure (SMD = −1.17, 95% CI (−1.52, −0.81)) respectively in favor of community management. Pooled data from all 11 researches showed a higher percentage of patients with blood pressure under control in favor of community management (OR = 3.85, 95% CI (1.58, 9.37)) and the difference between treatment group and control group on blood pressure control ratio had statistical significance (Z = 2.97, P < 0.01). It was declared that hypertension in elderly patients needs effective blood pressure (BP) management in a long time
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