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Risk Factors in Optimal Management of Hypertension in Elderly Patients Following 2017 American College of Cardiology—American Heart Association Guidelines
Introduction/Objectives: The 2017 American Heart Association hypertension management guidelines recommended optimal control of blood pressure under 130/80 mmHg. We aimed to study the factors associated with suboptimal and uncontrolled hypertension in the elderly patients. Methods: We performed a ret...
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| Published in: | Journal of primary care & community health 2024-01, Vol.15, p.21501319241306897 |
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| creator | Walder, Zachary Prasad, Satwiki Guevara, Adriana Souedy, Amine Al Martirosyan, Diana Moshman, Rachel Porter, Ashley Morris, Natalie Khatiwala, Pooja Thampi, Subhadra Hunter, Krystal Roy, Satyajeet |
| description | Introduction/Objectives:
The 2017 American Heart Association hypertension management guidelines recommended optimal control of blood pressure under 130/80 mmHg. We aimed to study the factors associated with suboptimal and uncontrolled hypertension in the elderly patients.
Methods:
We performed a retrospective review of suburban outpatient records of patients with hypertension, aged 65 years and older, and grouped into optimally controlled (OC; BP |
| doi_str_mv | 10.1177/21501319241306897 |
| format | article |
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The 2017 American Heart Association hypertension management guidelines recommended optimal control of blood pressure under 130/80 mmHg. We aimed to study the factors associated with suboptimal and uncontrolled hypertension in the elderly patients.
Methods:
We performed a retrospective review of suburban outpatient records of patients with hypertension, aged 65 years and older, and grouped into optimally controlled (OC; BP <130/80 mmHg), sub-optimally controlled (SOC; BP 130-139/80-89 mmHg), and uncontrolled (UC; BP≥140/90 mmHg) groups; and compared the associations of variables.
Results:
Among 1311 patients, there were 610 (46.5%) patients in OC, 391 (29.9%) in SOC, and 310 (23.6%) in UC groups. Mean ages were comparable (OC = 78 ± 8.1, SOC = 77 ± 7.4, UC = 78 ± 7.3 years; P = .760). In all groups, the majority of patients were White followed by BIPOC (Black-indigenous-and-other-people-of-color; OC = 78.5% vs 21.5%, SOC = 78.3% vs 21.7%, and UC = 71% vs 29%, respectively). There were more BIPOC patients in UC compared to OC group (29.0% vs 21.5%; P = .011). Mean body-mass-index (BMI) of patients in SOC and UC groups were greater than OC group (27.9 ± 6.3 vs 26.9 ± 6.3 kg/m2; P = .047; 28.1 ± 6.3 vs 26.9 ± 6.3 kg/m2; P = .027; respectively). There were significantly higher associations of certain comorbidities in SOC compared to OC group, such as transient ischemic attack (12.3% vs 3.6%; P < .001), hyperlipidemia (72.4% vs 56.2%; P < .001), atrial fibrillation (19.2% vs 11%; P < .001), HFpEF (5.4% vs 1.5%; P < .001), osteoarthritis (38.9% vs 30.5%; P = .006), malignancy (32.2% vs 19.5%; P < .001), and left ventricular hypertrophy (LVH; 27.4% vs 15.9%; P < .001). Logistic regression analysis showed that when compared to BIPOC, White race had lower odds of UC (OR = 0.63, 95% CI = 0.45-0.90). For every unit increase in BMI, there were greater odds of SOC (OR = 1.04, 95% CI = 1.01-1.06) and UC (OR = 1.04, 95% CI = 1.01-1.16). Patients with hyperlipidemia and LVH had greater odds of SOC (OR = 1.72, CI = 95% 1.25-2.37; and OR = 2.13, 95% CI = 1.02-4.43; respectively).
Conclusion:
In patients with sub-optimal and uncontrolled hypertension, there is a significantly higher association of BIPOC race, elevated BMI, hyperlipidemia, and left ventricular hypertrophy.]]></description><identifier>ISSN: 2150-1319</identifier><identifier>ISSN: 2150-1327</identifier><identifier>EISSN: 2150-1327</identifier><identifier>DOI: 10.1177/21501319241306897</identifier><identifier>PMID: 39676249</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Aged ; Aged, 80 and over ; American Heart Association ; Antihypertensive Agents - therapeutic use ; Blood Pressure ; Female ; Humans ; Hypertension - epidemiology ; Male ; Original Research ; Practice Guidelines as Topic ; Retrospective Studies ; Risk Factors ; United States</subject><ispartof>Journal of primary care & community health, 2024-01, Vol.15, p.21501319241306897</ispartof><rights>The Author(s) 2024</rights><rights>The Author(s) 2024 2024 SAGE Publications Inc unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3381-308c9b660a5bbc890953b222784ca3c2c97feb2f0676b54cb655e0c3eda713773</cites><orcidid>0000-0001-7104-4260 ; 0000-0002-1536-3678 ; 0000-0002-8991-2625</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648001/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648001/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,21965,27852,27923,27924,37012,44944,45332,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39676249$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Walder, Zachary</creatorcontrib><creatorcontrib>Prasad, Satwiki</creatorcontrib><creatorcontrib>Guevara, Adriana</creatorcontrib><creatorcontrib>Souedy, Amine Al</creatorcontrib><creatorcontrib>Martirosyan, Diana</creatorcontrib><creatorcontrib>Moshman, Rachel</creatorcontrib><creatorcontrib>Porter, Ashley</creatorcontrib><creatorcontrib>Morris, Natalie</creatorcontrib><creatorcontrib>Khatiwala, Pooja</creatorcontrib><creatorcontrib>Thampi, Subhadra</creatorcontrib><creatorcontrib>Hunter, Krystal</creatorcontrib><creatorcontrib>Roy, Satyajeet</creatorcontrib><title>Risk Factors in Optimal Management of Hypertension in Elderly Patients Following 2017 American College of Cardiology—American Heart Association Guidelines</title><title>Journal of primary care & community health</title><addtitle>J Prim Care Community Health</addtitle><description><![CDATA[Introduction/Objectives:
The 2017 American Heart Association hypertension management guidelines recommended optimal control of blood pressure under 130/80 mmHg. We aimed to study the factors associated with suboptimal and uncontrolled hypertension in the elderly patients.
Methods:
We performed a retrospective review of suburban outpatient records of patients with hypertension, aged 65 years and older, and grouped into optimally controlled (OC; BP <130/80 mmHg), sub-optimally controlled (SOC; BP 130-139/80-89 mmHg), and uncontrolled (UC; BP≥140/90 mmHg) groups; and compared the associations of variables.
Results:
Among 1311 patients, there were 610 (46.5%) patients in OC, 391 (29.9%) in SOC, and 310 (23.6%) in UC groups. Mean ages were comparable (OC = 78 ± 8.1, SOC = 77 ± 7.4, UC = 78 ± 7.3 years; P = .760). In all groups, the majority of patients were White followed by BIPOC (Black-indigenous-and-other-people-of-color; OC = 78.5% vs 21.5%, SOC = 78.3% vs 21.7%, and UC = 71% vs 29%, respectively). There were more BIPOC patients in UC compared to OC group (29.0% vs 21.5%; P = .011). Mean body-mass-index (BMI) of patients in SOC and UC groups were greater than OC group (27.9 ± 6.3 vs 26.9 ± 6.3 kg/m2; P = .047; 28.1 ± 6.3 vs 26.9 ± 6.3 kg/m2; P = .027; respectively). There were significantly higher associations of certain comorbidities in SOC compared to OC group, such as transient ischemic attack (12.3% vs 3.6%; P < .001), hyperlipidemia (72.4% vs 56.2%; P < .001), atrial fibrillation (19.2% vs 11%; P < .001), HFpEF (5.4% vs 1.5%; P < .001), osteoarthritis (38.9% vs 30.5%; P = .006), malignancy (32.2% vs 19.5%; P < .001), and left ventricular hypertrophy (LVH; 27.4% vs 15.9%; P < .001). Logistic regression analysis showed that when compared to BIPOC, White race had lower odds of UC (OR = 0.63, 95% CI = 0.45-0.90). For every unit increase in BMI, there were greater odds of SOC (OR = 1.04, 95% CI = 1.01-1.06) and UC (OR = 1.04, 95% CI = 1.01-1.16). Patients with hyperlipidemia and LVH had greater odds of SOC (OR = 1.72, CI = 95% 1.25-2.37; and OR = 2.13, 95% CI = 1.02-4.43; respectively).
Conclusion:
In patients with sub-optimal and uncontrolled hypertension, there is a significantly higher association of BIPOC race, elevated BMI, hyperlipidemia, and left ventricular hypertrophy.]]></description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>American Heart Association</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Blood Pressure</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension - epidemiology</subject><subject>Male</subject><subject>Original Research</subject><subject>Practice Guidelines as Topic</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>United States</subject><issn>2150-1319</issn><issn>2150-1327</issn><issn>2150-1327</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>DOA</sourceid><recordid>eNp9ks9uEzEQxlcIRKvQB-CCfOSS4j-79vqEoqhpKhUVIThbtneyODh2sHdBufEQHHk6ngQvKREVEr7YGn_zm_H4q6rnBF8SIsQrShpMGJG0JgzzVopH1fkUmxNGxePTmciz6iLnLS6r5oxx8rQ6Y5ILTmt5Xv145_IntNJ2iCkjF9DdfnA77dEbHXQPOwgDihu0PuwhDRCyi2FSXfkOkj-gt3pwRZLRKnofv7rQI4qJQIsdJGd1QMsShx4mxlKnzkUf-8PPb99PgjXoNKBFztG6Aiv469F14F2A_Kx6stE-w8X9Pqs-rK7eL9fz27vrm-Xidm4Za8mc4dZKwznWjTG2lVg2zFBKRVtbzSy1UmzA0A0ujzZNbQ1vGsCWQacFYUKwWXVz5HZRb9U-lQGkg4raqd-BmHpVmnTWg5KWEty2kne0rqnQxkDXWcyMkVB6mFivj6z9aHbQ2TKdpP0D6MOb4D6qPn5RhPC6xeVLZ9XLe0KKn0fIg9q5bMF7HSCOWTFS87YhrZyk5Ci1KeacYHOqQ7CaXKL-cUnJefF3g6eMP54ogsujIBcDqG0cUyjD_w_xFwK3x1w</recordid><startdate>20240101</startdate><enddate>20240101</enddate><creator>Walder, Zachary</creator><creator>Prasad, Satwiki</creator><creator>Guevara, Adriana</creator><creator>Souedy, Amine Al</creator><creator>Martirosyan, Diana</creator><creator>Moshman, Rachel</creator><creator>Porter, Ashley</creator><creator>Morris, Natalie</creator><creator>Khatiwala, Pooja</creator><creator>Thampi, Subhadra</creator><creator>Hunter, Krystal</creator><creator>Roy, Satyajeet</creator><general>SAGE Publications</general><general>SAGE Publishing</general><scope>AFRWT</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-7104-4260</orcidid><orcidid>https://orcid.org/0000-0002-1536-3678</orcidid><orcidid>https://orcid.org/0000-0002-8991-2625</orcidid></search><sort><creationdate>20240101</creationdate><title>Risk Factors in Optimal Management of Hypertension in Elderly Patients Following 2017 American College of Cardiology—American Heart Association Guidelines</title><author>Walder, Zachary ; Prasad, Satwiki ; Guevara, Adriana ; Souedy, Amine Al ; Martirosyan, Diana ; Moshman, Rachel ; Porter, Ashley ; Morris, Natalie ; Khatiwala, Pooja ; Thampi, Subhadra ; Hunter, Krystal ; Roy, Satyajeet</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3381-308c9b660a5bbc890953b222784ca3c2c97feb2f0676b54cb655e0c3eda713773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>American Heart Association</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Blood Pressure</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension - epidemiology</topic><topic>Male</topic><topic>Original Research</topic><topic>Practice Guidelines as Topic</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Walder, Zachary</creatorcontrib><creatorcontrib>Prasad, Satwiki</creatorcontrib><creatorcontrib>Guevara, Adriana</creatorcontrib><creatorcontrib>Souedy, Amine Al</creatorcontrib><creatorcontrib>Martirosyan, Diana</creatorcontrib><creatorcontrib>Moshman, Rachel</creatorcontrib><creatorcontrib>Porter, Ashley</creatorcontrib><creatorcontrib>Morris, Natalie</creatorcontrib><creatorcontrib>Khatiwala, Pooja</creatorcontrib><creatorcontrib>Thampi, Subhadra</creatorcontrib><creatorcontrib>Hunter, Krystal</creatorcontrib><creatorcontrib>Roy, Satyajeet</creatorcontrib><collection>SAGE Open Access Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of primary care & community health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Walder, Zachary</au><au>Prasad, Satwiki</au><au>Guevara, Adriana</au><au>Souedy, Amine Al</au><au>Martirosyan, Diana</au><au>Moshman, Rachel</au><au>Porter, Ashley</au><au>Morris, Natalie</au><au>Khatiwala, Pooja</au><au>Thampi, Subhadra</au><au>Hunter, Krystal</au><au>Roy, Satyajeet</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors in Optimal Management of Hypertension in Elderly Patients Following 2017 American College of Cardiology—American Heart Association Guidelines</atitle><jtitle>Journal of primary care & community health</jtitle><addtitle>J Prim Care Community Health</addtitle><date>2024-01-01</date><risdate>2024</risdate><volume>15</volume><spage>21501319241306897</spage><pages>21501319241306897-</pages><issn>2150-1319</issn><issn>2150-1327</issn><eissn>2150-1327</eissn><abstract><![CDATA[Introduction/Objectives:
The 2017 American Heart Association hypertension management guidelines recommended optimal control of blood pressure under 130/80 mmHg. We aimed to study the factors associated with suboptimal and uncontrolled hypertension in the elderly patients.
Methods:
We performed a retrospective review of suburban outpatient records of patients with hypertension, aged 65 years and older, and grouped into optimally controlled (OC; BP <130/80 mmHg), sub-optimally controlled (SOC; BP 130-139/80-89 mmHg), and uncontrolled (UC; BP≥140/90 mmHg) groups; and compared the associations of variables.
Results:
Among 1311 patients, there were 610 (46.5%) patients in OC, 391 (29.9%) in SOC, and 310 (23.6%) in UC groups. Mean ages were comparable (OC = 78 ± 8.1, SOC = 77 ± 7.4, UC = 78 ± 7.3 years; P = .760). In all groups, the majority of patients were White followed by BIPOC (Black-indigenous-and-other-people-of-color; OC = 78.5% vs 21.5%, SOC = 78.3% vs 21.7%, and UC = 71% vs 29%, respectively). There were more BIPOC patients in UC compared to OC group (29.0% vs 21.5%; P = .011). Mean body-mass-index (BMI) of patients in SOC and UC groups were greater than OC group (27.9 ± 6.3 vs 26.9 ± 6.3 kg/m2; P = .047; 28.1 ± 6.3 vs 26.9 ± 6.3 kg/m2; P = .027; respectively). There were significantly higher associations of certain comorbidities in SOC compared to OC group, such as transient ischemic attack (12.3% vs 3.6%; P < .001), hyperlipidemia (72.4% vs 56.2%; P < .001), atrial fibrillation (19.2% vs 11%; P < .001), HFpEF (5.4% vs 1.5%; P < .001), osteoarthritis (38.9% vs 30.5%; P = .006), malignancy (32.2% vs 19.5%; P < .001), and left ventricular hypertrophy (LVH; 27.4% vs 15.9%; P < .001). Logistic regression analysis showed that when compared to BIPOC, White race had lower odds of UC (OR = 0.63, 95% CI = 0.45-0.90). For every unit increase in BMI, there were greater odds of SOC (OR = 1.04, 95% CI = 1.01-1.06) and UC (OR = 1.04, 95% CI = 1.01-1.16). Patients with hyperlipidemia and LVH had greater odds of SOC (OR = 1.72, CI = 95% 1.25-2.37; and OR = 2.13, 95% CI = 1.02-4.43; respectively).
Conclusion:
In patients with sub-optimal and uncontrolled hypertension, there is a significantly higher association of BIPOC race, elevated BMI, hyperlipidemia, and left ventricular hypertrophy.]]></abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>39676249</pmid><doi>10.1177/21501319241306897</doi><orcidid>https://orcid.org/0000-0001-7104-4260</orcidid><orcidid>https://orcid.org/0000-0002-1536-3678</orcidid><orcidid>https://orcid.org/0000-0002-8991-2625</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of primary care & community health, 2024-01, Vol.15, p.21501319241306897 |
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| language | eng |
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| source | Publicly Available Content Database; SAGE Open Access Journals; PubMed Central |
| subjects | Aged Aged, 80 and over American Heart Association Antihypertensive Agents - therapeutic use Blood Pressure Female Humans Hypertension - epidemiology Male Original Research Practice Guidelines as Topic Retrospective Studies Risk Factors United States |
| title | Risk Factors in Optimal Management of Hypertension in Elderly Patients Following 2017 American College of Cardiology—American Heart Association Guidelines |
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