Blood Pressure and Hypertension Among Adults Aged 80 and Above: Findings From the Population‐Based German Health Survey Gesundheit 65+

Background: Hypertension is highly prevalent in older adults; therefore, hypertension management remains essential. Nevertheless, population data is scarce. Until recently, population blood pressure (BP) monitoring in Germany only included the population up to age 79. This study investigates BP and hypertension management in octogenarians and nonagenarians in Germany from the study Gesundheit 65+. Methods: In 2022-2023, brachial BP measurements (Mobil-O-Graph, IEM GmbH, Aachen/Germany) and health questionnaires were conducted in 807 participants aged 80-99 years of the German population-based Gesundheit 65+ study. Hypertension was defined as BP ≥ 140/90 mmHg, or antihypertensive treatment in participants with self-reported hypertension. Hypertension control was defined as BP < 140/90 mmHg among participants with hypertension. Weighted prevalence of hypertension, awareness, treatment and control by sex were estimated with 95% confidence intervals (CIs). Partitioning Around Medoids cluster analysis was performed to identify distinct subtypes among participants with hypertension. Results: The prevalence of hypertension in women was 77.8% [95% CI: 71.4-83.2] and in men 72.3% [65.7-78.0]. Among those with hypertension, 85.2% were aware, 81.7% treated, and 57.3% controlled. Control was significantly lower in women compared to men, with half of women having controlled hypertension, compared to two-thirds of men. The cluster analysis revealed two subgroups among women with hypertension: a well-treated/controlled but multimorbid group and an untreated/uncontrolled but subjectively healthier group. Three clusters emerged among men with hypertension: treated/controlled, less treated/uncontrolled and a severely multimorbid cluster with high treatment and control rates. Conclusion: Among octogenarians and nonagenarians in Germany, hypertension prevalence is higher in women than in men, while hypertension control among women is lower. This underscores the need for more attention to BP in older women. Furthermore, our findings indicate that high BP, as a largely asymptomatic health risk, may be inadequately controlled among otherwise healthy older adults.