June 1, 1996Open Access
View Full PaperEffects of gender and ethnic group on blood pressure control in the elderly
Key Result
Among treated elderly hypertensives, women were 52% more likely than men, and Black patients were 40% less likely than White patients, to exhibit adequate blood pressure control.
Study Design
Type
Cross-Sectional (n=4,162)
Structured PICO
Does gender and ethnic group affect the adequacy of blood pressure control in elderly treated hypertensives?
P
Population
4,162 noninstitutionalized adults aged 65 years or older (mean age 73, 65% female) in Central North Carolina, assessed for blood pressure control.
E
Exposure
Antihypertensive treatment (observational)
C
Comparator
Comparison between genders (women vs men) and ethnic groups (blacks vs whites)
O
Outcome
Adequate blood pressure control (measured diastolic blood pressure of 90 mm Hg or lower)surrogate
Elderly women are more likely than men, and elderly blacks are less likely than whites, to have adequately controlled blood pressure on treatment.
Main Result
Effect estimate: 52% more likely (women vs men); 40% less likely (blacks vs whites)
Abstract
In order to determine the adequacy of blood pressure treatment in black and white elderly men and women, the authors performed a cross-sectional population survey in Central North Carolina in 1986-1987. Participants included a random sample of noninstitutionalized individuals age 65 years or older. Blacks were oversampled. A health questionnaire was administered, and blood pressure was measured. Of 5,223 eligible persons, 4,162 (80%) participated. Fifty-four percent of subjects were black and 65% were women. Sixteen percent of the study subjects were white men, 30% white women, 19% black men, and 35% black women. The mean age was 73 years. Fifty-three percent had hypertension. Among hypertensives, 80.8% were taking blood pressure medication. Among treated hypertensives, blood pressure was adequately controlled, (measured diastolic blood pressure of 90 mm Hg or lower) in 85.6%. Women were 52% more likely than men and blacks were 40% less likely than whites to exhibit adequate blood pressure control. Older age and smoking were also associated with better blood pressure control. The authors conclude that hypertension is more likely to be controlled in elderly women than men and less likely to be well-controlled in elderly blacks than whites. The choice of antihypertensive agent may also be important. Further investigation is needed into the mechanisms accounting for the observed sex and race differences.