Antihypertensive Treatment Patterns and Blood Pressure Control in Older Adults: Results from the Berlin Aging Study II

König, Maximilian; Gollasch, Maik; Rosada, Amrina; Demuth, Ilja; Spira, Dominik; Steinhagen‐Thiessen, Elisabeth

doi:10.1007/s40266-018-0580-0

Cited by 12 publications

(8 citation statements)

References 42 publications

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“…Attended automated BP measurements in the seated position were performed according to a standard protocol using a validated electronic device (boso–medicus memory, Jung Willingen, Germany) as previously reported [ 8 , 19 ]. For each participant, two BP measurements for SBP and DBP were performed, one on the right and one on the left arm [ 8 ]. The mean of these values was used for statistical analysis and only subjects with complete SBP and DBP measurements were included ( n = 1529).…”

Section: Methodsmentioning

confidence: 99%

“…Based on this hypothesis, early identification of individuals at risk might implicitly lead to more effective implementation of preventative lifestyle modifications, optimal BP control and careful follow-up. The age-related increase in BP, particularly systolic BP (SBP), results in a high prevalence of hypertension above 70% among individuals older than 65 years [ 6 – 8 ]. The potential interrelation of BP with cognitive function has received explicit attention from epidemiologic research with mounting evidence supporting their association [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Effect of a common UMOD variant on kidney function, blood pressure, cognitive and physical function in a community-based cohort of older adults

et al. 2021

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In genome-wide association studies, genetic variants in the UMOD gene associate with kidney function, blood pressure (BP), and hypertension. Elevated BP is linked to kidney function and impaired cognitive as well as physical performance in later life. We investigated the association between UMOD rs4293393–A > G and kidney function, BP, cognitive and physical function in the Berlin Aging Study II (BASE–II). Data of 1556 older BASE–II participants (mean age 68.2 ± 3.7 years) were analyzed. BP was determined by standardized automated measurements, estimated glomerular filtration rate (eGFR) by CKD Epidemiology Collaboration creatinine equation. Cognitive function was assessed by Mini-Mental State Examination and Digit Symbol Substitution Test, while physical function by Handgrip Strength and Timed Up and Go-Test. Association analyses were performed by covariance and logistic regression models adjusting for sex. G–allele carriers at UMOD rs4293393 exhibited significantly higher eGFR values compared to non–carriers (AA, 76.4 ml/min/1.73 m², CI: 75.7–77.2 vs. AG, 78.4 ml/min/1.73 m², CI: 77.3–79.5 vs. GG, 78.5 ml/min/1.73 m², CI: 75.4–81.7; P = 0.010), and a lower risk of eGFR < 60 mL/min/1.73 m2 (AG, OR: 0.63, CI: 0.41–0.97, P = 0.033). However, UMOD rs4293393 genotypes were not associated with BP, diagnosis of hypertension or cognitive and physical function parameters. Our data corroborate previous findings on the association of UMOD rs4293393-G with better kidney function in older adults. However, no association between UMOD and BP or physical and cognitive parameters in these community-dwelling older adults was detected.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of a common UMOD variant on kidney function, blood pressure, cognitive and physical function in a community-based cohort of older adults

et al. 2021

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“…Despite international guidelines to diagnose and treat hypertension [1,2], still one-half to one-fifth of treated patients with hypertension is inadequately managed [3,4]. Several factors associated with inadequate management have been identified, such as male gender, lower educational level, ethnicity, or increasing age [5][6][7]. Recently, several genetic variants have been associated with lower control levels of hypertension [8][9][10] and the development of a pharmacogenetic test for hypertension has been suggested [11].…”

Section: Introductionmentioning

confidence: 99%

Association between genetic risk of high SBP and hypertension control: the CoLaus|PsyColaus study

Marques‐Vidal

Chekanova

Vaucher

2022

Journal of Hypertension

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Objective: To assess whether a genetic risk score (GRS) for high SBP is associated with poor control of hypertension.Methods: Data from the four waves of a populationbased, prospective study conducted in Lausanne, Switzerland. Control of hypertension was defined based on SBP less than 140 mmHg and DBP less than 90 mmHg. A weighted GRS was computed from 362 SNPs.Results: Overall, 1097 (51% men, mean age 61 years), 1126 (53% men, age 65 years), 1020 (52% men, age 69 years) and 809 (50% men, age 71 years) participants treated for hypertension were selected from the baseline (2003-2006), first (2009-2012), second (2014-2017) and third (2018-2021) surveys. Hypertension control rates were 50, 58, 52 and 59% for the baseline, first, second and third surveys, respectively. No association was found between GRS and hypertension control: multivariateadjusted mean AE standard error for controlled vs. uncontrolled participants: 9.30 AE 0.09 vs. 9.50 AE 0.09 (P ¼ 0.12); 9.32 AE 0.08 vs. 9.53 AE 0.10 (P ¼ 0.10); 9.17 AE 0.08 vs. 9.34 AE 0.11 (P ¼ 0.22), and 9.18 AE 0.09 vs. 9.46 AE 0.11 (P ¼ 0.07) for the baseline, first, second and third surveys, respectively. Power analysis showed that a minimum of 3410 people treated for hypertension would be necessary to detect an association between the GRS and hypertension control rates. Notably, positive associations between the GRS and SBP levels were found among participants not treated for hypertension, with Spearman correlations ranging between 0.05 and 0.09 (all P < 0.05). Conclusion:Using a GRS associated with SBP levels is not predictive of hypertension control. The use of GRS for hypertension management is not warranted in clinical practice.

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“…A Chinese study showed that calcium channel blockers were the most prescribed medications in the evaluated population ( 17 ). Other studies showed that ACEi/ARBs were the most often prescribed medications among young or elderly adults ( 18 , 19 ). In our study, there was a greater proportion of RAASi use among the participants from the older age groups, of White ethnicity, and those with comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with non-treatment of hypertension and gender differences at baseline in the ELSA-Brasil cohort

Néri,

Xavier,

Matos

et al. 2024

Braz J Med Biol Res

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The treatment of arterial hypertension (AH) contributes to the reduction of morbidity and mortality. Gender differences are likely to play a role, as non-treatment is associated with clinical and sociodemographic aspects. The aim of this study was to investigate the factors associated with non-treatment of AH and gender differences in hypertensive individuals from the ELSA-Brasil cohort. The study was conducted with 5,743 baseline hypertensive cohort participants. AH was considered if there was a previous diagnosis or if systolic blood pressure (SBP) was ≥140 and/or diastolic BP (DBP) was ≥90 mmHg. Sociodemographic and anthropometric data, lifestyle, comorbidities, and use of antihypertensive medications were evaluated through interviews and in-person measurements. Treatment with renin-angiotensin-aldosterone system inhibitors (RAASi) or other antihypertensive medications and non-treatment were evaluated with multivariate logistic regression. Non-treatment was observed in 32.8% of hypertensive individuals. Of the 67.7% treated individuals, 41.1% received RAASi. Non-treatment was associated with alcohol consumption in women (OR=1.41; 95%CI: 1.15-1.73; P=0.001), lowest schooling level in men (OR=1.70; 95%CI: 1.32-2.19; P<0.001), and younger age groups in men and women (strongest association in males aged 35-44 years: OR=4.58, 95%CI: 3.17-6.6, P<0.001). Among those using RAASi, a higher proportion of white, older individuals, and with more comorbidities was observed. The high percentage of non-treatment, even in this civil servant population, indicated the need to improve the treatment cascade for AH. Public health policies should consider giving special attention to gender roles in groups at higher risk of non-treatment to reduce inequities related to AH in Brazil.

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Antihypertensive Treatment Patterns and Blood Pressure Control in Older Adults: Results from the Berlin Aging Study II

Abstract: The majority of older adults do not reach BP goals. Antihypertensive prescription patterns do not conform to current guidelines. Using more BP medications was not associated with higher odds of BP control. Lowering LDL-C might be favorable in terms of BP control.

Cited by 12 publications

References 42 publications

Effect of a common UMOD variant on kidney function, blood pressure, cognitive and physical function in a community-based cohort of older adults

Effect of a common UMOD variant on kidney function, blood pressure, cognitive and physical function in a community-based cohort of older adults

Association between genetic risk of high SBP and hypertension control: the CoLaus|PsyColaus study

Factors associated with non-treatment of hypertension and gender differences at baseline in the ELSA-Brasil cohort

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