• 作者：José ; L. Llisterri^a ; ^{jllisterric@medynet.com} ; Francisco J. Alonso^b ; Manuel Gorostidi^c ; Cristina Sierra^d ; Alejandro de La Sierra^d ; José ; R. Banegas^e ; Juliá ; n Segura^f ; Javier Sobrino^g ; Juan J. De La Cruz^e ; Felipe Madruga^h ; Pedro Arandaⁱ ; Josep Redon^j ; Luis M. Ruilope^f ; en representació ; n de los investigadores del Proyecto CARDIORISC-MAPAPRES. Sociedad Españ ; ola de Hipertensió ; n-Liga Españ ; ola para la Lucha contra la Hipertensió ; n Arterial (SEH-LELHA)
• 关键词：Presió ; n arterial ; Ancianos ; Monitorizació ; n ambulatoria de la presió ; n arterial
• 刊名：Medicina Cl铆nica
• 出版年：2009
• 期刊代码：pca254_00257753
• 类别：med
• 出版时间：28 November 2009
• 卷：133
• 期：20
• 页码：769-776
• 文件大小：278 K

Background and objective

Hypertension is highly prevalent in the very elderly. We studied control rates of hypertension according to clinic blood pressure (BP) and ambulatory BP monitoring (ABPM) in treated hypertensives aged 鈮?0 years.

Patients and method

Data came from the Spanish Society of Hypertension ABPM Registry (CARDIORISC 鈥?MAPAPRES project), which comprises a nation-wide network of more than 1,000 physicians sending standardized ABPM registries via web. Between June 2004 and April 2007 we obtained a 33.829-patient database. Control of hypertension was defined at the clinic when office BP was <140/90 mmHg and at the ABPM when mean BP during the 24-h period was <130/80 mmHg.

Results

We identified 2,311 patients (6.8%) aged 鈮?0 years. Mean age (SD) was 83.1 (3.2) years and 63%were women. Control of clinic BP was observed in 21.5%of cases (95%CI: 19.1鈥?3.9) and control of 24-h BP in ABPM was 42.1%(95%CI: 39.7鈥?5.3). Prevalence of masked hypertension was 7.0%(95%CI: 6.0鈥?.0) and prevalence of office-resistant control (white coat) was 27.6%(95%CI: 25.7鈥?9.4). Diabetes, kidney disease, and duration of hypertension were associated with lack of control in ABPM.

Conclusions

In very old hypertensives, control of clinic BP was 21.5%but ambulatory-based hypertension control was 42.1%. Physicians should be aware that the likelihood of misestimating BP control is high in these subjects. A wider use of ABPM in the elderly with hypertension should be considered.