High Blood Pressure Control in Older Americans

12-9. Reduce the proportion of adults with high pressure.

12-10. Increase the proportion of adults with high blood pressure whose blood pressure is under control.

12-12. Increase the proportion of adults who have had their blood pressure measured within the preceding 2 years and can state whether their blood pressure was normal or high.

Detect and Treat Risk Factors

Increase the percentage of patients who have their CVD risk factors detected and who implement lifestyle and/or pharmacologic intervention and successfully control their blood pressure and cholesterol levels and weight to prevent the development of CVD.

The overall objective of this multilevel performance project is to use professional, patient, and public education to increase awareness of the importance of systolic blood pressure as the major criterion for diagnosis, staging, and treatment of hypertension in older Americans.

Striking benefits of lowering blood pressure among older Americans have been shown in numerous clinical trials. Blood pressure lowering has been demonstrated to reduce incidence of strokes, coronary events, heart failure, progression of renal disease, progression to severe hypertension, and all-cause mortality. NHANES III data indicate that the control rate for all hypertensive is less than 27 percent, and for those ages 70 or older, it is considerably worse. Estimates for patient noncompliance with blood pressure medication regimens range from 18 to 50 percent.

There is a misconception among the public and many clinicians that because blood pressure rises with age it is a normal part of the aging process, and thus, little should be done to lower elevated pressure among older Americans. In addition, limited attention has been directed to control of systolic blood pressure despite evidence that it is more important than diastolic blood pressure in predicting cardiovascular risk.

The combination of these factors has demonstrated the need for focused efforts on increasing awareness in both the professional and patient/public populations. An outreach campaign has been started to increase awareness among hypertensive older Americans, the general public, high-risk minority groups, and health professionals. A website was also developed to support these efforts.