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Revista Clínica de Medicina de Familia
versão On-line ISSN 2386-8201versão impressa ISSN 1699-695X
Resumo
ABADIA-CASCAJERO, Marta Ángela; ALONSO-SAFONT, Tamara e MARTIN-FERNANDEZ, Jesús. Impact of blood pressure monitoring on morbidity and mortality in hypertensive patients aged 65 years and over in the community setting. Rev Clin Med Fam [online]. 2023, vol.16, n.1, pp.17-23. Epub 17-Abr-2023. ISSN 2386-8201. https://dx.doi.org/10.55783/rcmf.160104.
Objective:
to assess the impact of blood pressure (BP) control on morbidity and mortality in over 65-year-olds, without previous cardiovascular pathology, in a community setting.
Methods:
retrospective cohort study. All patients (≥65 years) with a diagnosis of HT (01/01/2007-31/12/2008), without previous cardiovascular events (CVD), with at least two BP recordings in the first year of follow-up) from every health centres in the Community of Madrid were included (n = 17,150). The occurrence of CVD (including CV mortality) and total mortality were assessed using Cox regression.
Results:
the median follow-up for mortality was 129.58 months (IQR: 120.41-136.94 months). There were 8,641 CVDs and 4,073 deaths from any cause. Adjusted for gender, hypertension severity, smoking, diabetes, and hypercholesterolemia, good control (BP < 140/90 mmHg) was not associated with a decrease in CVD, but was associated with a 14.41% decrease in mortality (HR 0.8559, 95% CI: 0.7776- 0.9421) between 75 and 84 years. When threshold of 130/80 mmHg is used to define good control, this was associated with an excess mortality of 43.58% (95% CI 19.60-72.36%) between 65 and 74 years and 61.22% (95% CI 22.99-111.35%) in subjects aged 85 and over.
Conclusion:
BP control in people over 65 years of age is associated with a slight decrease in mortality between 75 and 84 years of age. Tighter control figures are associated with a higher incidence of CVD and mortality, especially in the older age group.
Palavras-chave : Hypertension; Indicators of Morbidity and Mortality; Primary Health Care; Health of the Elderly.