Prevalence of Eligibility Criteria for the Systolic Blood Pressure Intervention Trial in US Adults Among Excluded Groups: Age <50 Years, Diabetes Mellitus, or a History of Stroke

Objective. To explore the proportion and characteristic of Chinese adults meeting The Systolic Blood Pressure Intervention Trial (SPRINT) eligibility criteria and assess its generalizability. Method. Our study was based on a cross-sectional, population-based survey with a sample of 26,093 participants aged over 20 years. The SPRINT eligibility criteria were age ≥ 50 years, elevated SBP of 130 to 180 mmHg depending on the number of antihypertensive medication classes being taken, and increased cardiovascular disease (CVD) but without diabetes, history of stroke and estimated glomerular filtration rate < 20 ml / min / 1.73 m 2 , or receiving dialysis. Results. Overall, we estimated that 4,036 (15.5%) participants would meet the SPRINT eligibility criteria. They were generally older, likely to be female, lower educational level, tended to be more overweight, and had higher Framingham risk score compared with overall population or subjects aged ≥ 50 years. Of participants eligible for SPRINT, most (56.2%) of them were not treated for hypertension, and 542 (13.4%) were not previously considered to have hypertension or need for antihypertension therapy. Among the 11,637 adults with hypertension, 3,494 (30.0%) would potentially benefit from treatment intensification. The most common antihypertensive medication class being taken was diuretic agents. Conclusion. A substantial percentage of Chinese subjects meet the SPRINT eligibility criteria. Further studies are needed to assess the cost-effectiveness from treatment intensification in Chinese setting.

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Arterial hypertension in elderly and senile patients: clinical characteristics and treatment quality (according to the national register of arterial hypertension)

Siberian Medical Journal ◽

10.29001/2073-8552-2019-34-3-73-86 ◽

2019 ◽

Vol 34 (3) ◽

pp. 73-86

Author(s):

A. V. Aksenova ◽

E. V. Oshchepkova ◽

A. A. Orlovsky ◽

I. E. Chazova

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Arterial Hypertension ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Medical Records ◽

Older Patients ◽

Clinical Characteristics ◽

Target Values ◽

History Of

Introduction. The importance of studying treatment in older hypertensive patients is underlined by the tendency to aging of the population as a whole. During recent years, the approach to therapy of older patients changed. The guidelines on management of arterial hypertension recommend lower target blood pressure values and earlier start of the treatment.Aim. To study the quality of arterial hypertension treatment and clinical characteristics in older patients (≥65 years).Material and Methods. The Russian national registry of hypertension was conducted in 22 regions of the Russian Federation since 2012. It included 53 city primary health care centers and five cardiology clinics. The data were analyzed in two groups comprised of 65 to 79-year-old individuals and patients older than 80 years. Data on physical, instrumental, and laboratory examinations, as well as data regarding antihypertensive and lipid-lowering therapy and comorbidities, were analyzed.Results: Patients aged 65 to 79 years and those older than 80 years had coronary artery disease (42.7% and 55.5%), chronic heart failure (CHF) (46.8% and 55.7%), history of Q-wave myocardial infarction (MI) (6.4% and 5.9%), stroke (5.5% and 5.7%), atrial fibrillation/flutter (3.7% and 6.5%), chronic kidney disease (CKD) stage 3–5 (36.6% and 48.4%), and diabetes mellitus (19.4% and 13.4%). Following the guidelines on management of arterial hypertension 2013, the target values of systolic blood pressure were achieved in 30% of patients; target values of diastolic blood pressure were reached in 60% of patients. Decreases in systolic blood pressure lower than <120 mmHg and in diastolic blood pressure lower than 70 mmHg were found in 3% of patients. In accordance with Guidelines 2018, target values of systolic blood pressure were achieved in 21–24% of patients; target values of diastolic blood pressure were achieved in 12–13% patients. Ambulatory 24-h blood pressure monitoring was performed only in 2.8% of 65–79-year-old patients and in 1.9% of patients older than 80 years. Data on antihypertensive therapy were absent in 13% of medical records of patients who had indications for it. Medical records of 20% of patients with history of Q-wave MI, CHF, diabetes mellitus, and CKD did not contain data on administration of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Administration of beta-blockers and mineralocorticoid receptor antagonists in patients with hypertension and chronic heart failure was insufficient. Achievement of target cholesterol levels was insufficient in both age groups.

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