Hypertension in Elderly People in a Swedish Primary Care District

Abstract

In a retrospective study, 124 hypertensives aged 60-69 years, and taken care of by primary health care, were compared with 124 age and sex matched controls with regard to blood pressure, body mass index, smoking and alcohol habits as well as cardiovascular diseases. Blood pressure, mean +/- SEM (mm Hg) was reduced by 37/24 in males and 40/24 in females. Drug treatment was given to 93 per cent of the patients. Our goal of treatment - blood pressure 180/100 or below - was obtained in 75 per cent of the patients. Cardiovascular diseases were more common in male hypertensives than in their controls. The relative odds of stroke in male hypertensives treated within the primary health care organisation was estimated to 7.7 (1.3-45.3) and of cardiovascular diseases to 4.3 (1.7-10.1). In a ten year prospective cohort study of all pensioners in the primary care district, born in 1902 and 1903, a subcohort of pensioners with hypertension and under medical treatment when they were 70 years old (n = 39) was compared with the subcohort of pensioners without hypertension at this age (n = 105). This study comprised 342 person-years in the former subcohort and 889 person-years in the latter. No significant differences in mortality nor in cardiovascular morbidity were found between the subcohorts. The results of the two studies showed higher risks for male hypertensives aged 60-69 years who are taken care of by primary health care compared with those aged 70-80 years in spite of the latter group being older, having higher systolic blood pressure at the examinations and less degree of antihypertensive drug treatment. This shows that hypertension as a risk indicator for cardiovascular diseases may differ between age groups above 60 years.