University of L'Aquila, Department of Life, Health and Environmental Sciences, San Salvatore Hospita, (the Italian Society of Hypertension)l, L'Aquila, Italy.
Department of Medicine, Division of Nephrology and Hypertension, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, Ohio 44106, United States.
Curr Pharm Des. 2021;27(16):1952-1959. doi: 10.2174/1381612826666201207230956.
Hypertension control is a crucial measure to reduce cardiovascular (CV) risk, and blood pressure (BP) treatment targets have been recently revised to address this issue. However, achieving the recommended goal may be challenging.
We aimed to assess the prevalence of uncontrolled hypertension, according to the US hypertension guidelines, among elderly participants in an Italian nationwide epidemiological survey, the relevant clinical correlates, and the agreement with the application of the European guidelines.
Elderly (≥65y) volunteers enrolled in an Italian nationwide survey underwent BP measurement using standard protocols. Uncontrolled hypertension was defined as BP≥130/80 mmHg. Agreement of this definition with those from European guidelines (≥140/90 mmHg; ≥140/80 mmHg) was tested using Cohen's kappa. Selfreported information on modifiable/non-modifiable CV risk factors was also collected.
Of the 13,162 treated hypertensive elderly, 69.8% had uncontrolled hypertension. They tended to be overweight/obese men with diabetes. Overall agreement between US and European guidelines was poor to good (κ = 0.289, p<0.001 and κ = 0.691, p<0.001 based on the 140/90 and 140/80 mmHg threshold, respectively). Elderly participants with controlled hypertension were more likely to report a history of CV or chronic kidney disease. No difference in lifestyle habits was observed by BP control status.
Real-world data identify limited concordance between guidelines in terms of BP target achievement among older hypertensive Italians and highlights the need to spread awareness of the CV risk, especially in the presence of diabetes and obesity.
高血压控制是降低心血管（CV）风险的关键措施，最近修订了血压（BP）治疗目标以解决这一问题。然而，实现推荐的目标可能具有挑战性。
我们旨在评估意大利全国性流行病学调查中老年人参与者中根据美国高血压指南定义的未控制高血压的患病率、相关临床相关性以及与应用欧洲指南的一致性。
参加意大利全国性调查的老年（≥65 岁）志愿者使用标准方案测量血压。未控制的高血压定义为 BP≥130/80mmHg。使用 Cohen's kappa 检验评估该定义与欧洲指南（≥140/90mmHg；≥140/80mmHg）的一致性。还收集了关于可改变/不可改变的 CV 危险因素的自我报告信息。
在 13162 名接受治疗的高血压老年患者中，69.8%的患者血压未得到控制。他们往往是超重/肥胖的男性，患有糖尿病。美国和欧洲指南之间的总体一致性较差至较好（基于 140/90mmHg 和 140/80mmHg 阈值，κ=0.289，p<0.001 和 κ=0.691，p<0.001）。血压控制良好的老年患者更有可能报告有 CV 或慢性肾脏疾病病史。血压控制状况对生活方式习惯无差异。
真实世界的数据表明，在意大利老年高血压患者中，BP 目标实现方面的指南之间存在有限的一致性，并强调需要提高对 CV 风险的认识，特别是在存在糖尿病和肥胖的情况下。
