Cheong A T, Sazlina S G, Tong S F, Azah A S, Salmiah S
Cheong Ai Theng MMed (Fam Med) Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra, Malaysia, Serdang, 43400 Selangor, Malaysia. Email:
Shariff-Ghazali Sazlina MMed (Fam Med), PhD Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400 Selangor, Malaysia.
Malays Fam Physician. 2015 Apr 30;10(1):19-25. eCollection 2015.
Hypertension is highly prevalent in the older people. Chronic disease care is a major burden in the public primary care clinics in Malaysia. Good blood pressure (BP) control is needed to reduce the morbidity and mortality of cardiovascular disease (CVD). This study aimed to determine the status of BP control and its associated factors among older people with hypertension in public primary care clinics.
A cross-sectional study on hypertensive patients aged 18 years and above was conducted in six public primary care clinics in Federal Territory, Malaysia. A total of 1107 patients were selected via systematic random sampling. Data from 441 (39.8%) patients aged 60 years and more were used in this analysis. BP control was determined from the average of two BP readings measured twice at an interval of 5 min. For patients without diabetes, poor BP control was defined as BP of ≥140/90 mm Hg and ≥150/90 for the patients aged 80 years and more. For patients with diabetes, poor control was defined as BP of ≥140/80 mm Hg.
A total of 51.7% (n = 228) of older patients had poor BP control. The factors associated with BP control were education level (p = 0.003), presence of comorbidities (p = 0.015), number of antihypertensive agents (p = 0.001) and number of total medications used (p = 0.002). Patients with lower education (less than secondary education) (OR = 1.7, p = 0.008) and the use of three or more antihypertensive agents (OR = 2.0, p = 0.020) were associated with poor BP control.
Among older people with hypertension, those having lower education level, or using three or more antihypertensive agents would require more attention on their BP control.
高血压在老年人中非常普遍。慢性病护理是马来西亚公立基层医疗诊所的一项主要负担。需要良好的血压控制以降低心血管疾病（CVD）的发病率和死亡率。本研究旨在确定公立基层医疗诊所中高血压老年人的血压控制状况及其相关因素。
在马来西亚联邦直辖区的六家公立基层医疗诊所对18岁及以上的高血压患者进行了一项横断面研究。通过系统随机抽样共选取了1107名患者。本分析使用了441名（39.8%）60岁及以上患者的数据。血压控制是根据每隔5分钟测量两次的两次血压读数的平均值来确定的。对于无糖尿病患者，血压控制不佳定义为血压≥140/90 mmHg，80岁及以上患者为≥150/90 mmHg。对于糖尿病患者，控制不佳定义为血压≥140/80 mmHg。
共有51.7%（n = 228）的老年患者血压控制不佳。与血压控制相关的因素有教育水平（p = 0.003）、合并症的存在（p = 0.015）、抗高血压药物数量（p = 0.001）和所用药物总数（p = 0.002）。教育程度较低（低于中学教育）的患者（OR = 1.7，p = 0.008）以及使用三种或更多抗高血压药物的患者（OR = 2.0，p = 0.020）与血压控制不佳有关。
在高血压老年人中，教育水平较低或使用三种或更多抗高血压药物的患者在血压控制方面需要更多关注。
