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Changes in hypertension control in a community-based population of older adults, 2011-2013 to 2016-2017.

TitleChanges in hypertension control in a community-based population of older adults, 2011-2013 to 2016-2017.
Publication TypeJournal Article
Year of Publication2020
AuthorsFoti K, Matsushita K, Koton S, Walker KA, Coresh JJ, Appel LJ, Selvin E
JournalAm J Hypertens
Date Published2020 Dec 05
ISSN1941-7225
Abstract

BACKGROUND: The 2014 hypertension guideline raised treatment goals in older adults. The study objective was to examine changes in blood pressure (BP) control (

METHODS: Participants were 1600 white and 650 Black adults aged 71-90 years in the Atherosclerosis Risk in Communities (ARIC) Study with treated hypertension in 2011-2013 (baseline) who had BP measured in 2016-2017 (follow up). Factors associated with changes in BP control were examined by race.

RESULTS: BP was controlled among 75.3% of white and 65.7% of Black participants at baseline and 59.0% of white and 56.5% of Black participants at follow up. Among those with controlled BP at baseline, risk factors for incident uncontrolled BP included age (RR 1.15 per 5 years, 95% CI 1.07-1.25), female sex (RR 1.36, 95% CI 1.16-1.60), and chronic kidney disease (CKD) (RR 1.19, 95% CI 1.01-1.40) among white participants, and hypertension duration (RR 1.14 per 5 years, 95% CI 1.03-1.27) and diabetes (RR 1.48, 95% CI 1.15-1.91) among Black participants. Among those with uncontrolled BP at baseline, white females vs males (RR 0.60, 95% CI 0.46-0.78) and Black participants with CKD vs without (RR 0.58, 95% CI 0.36-0.93) were less likely to have incident controlled BP.

CONCLUSIONS: BP control decreased among white and Black older adults. Black individuals with diabetes or CKD were less likely to have controlled BP at follow up. Higher treatment goals may have contributed to these findings and unintended differences by race.

DOI10.1093/ajh/hpaa206
Alternate JournalAm J Hypertens
PubMed ID33277992
Grant ListK24 HL152440 / HL / NHLBI NIH HHS / United States
R01 DK089174 / DK / NIDDK NIH HHS / United States