Key result
Increasing patient age was associated with a lower likelihood of being diagnosed with hypertension (OR 0.98 per year age increase), though age did not affect the probability of receiving treatment.
Why the study?
Does increasing patient age reduce the likelihood of hypertension diagnosis and treatment in primary care patients aged 60 years or older?
Cohort (n=19,500)
Yes
Does increasing patient age reduce the likelihood of hypertension diagnosis and treatment in primary care patients aged 60 years or older?
General practitioners are less inclined to diagnose hypertension with increasing patient age, but do not withhold treatment once hypertension is diagnosed in older patients.
GPs diagnose hypertension less often with advancing age but treat similarly once diagnosed; observational data leave open whether this reflects appropriate caution or underdiagnosis.
BACKGROUND: It is unknown to what extent General Practitioners (GPs) manage hypertension (HT) differently in older patients, as compared to younger age groups. The purpose of our study was to compare HT management in older patients to younger age groups. METHODS: We performed a retrospective cohort study of patients of 159 GP's practices in the Integrated Primary Care Information (IPCI) database. The study period lasted from September 2010 through December 2012. The study population consisted of all patients aged 60 years or older with at least one blood pressure (BP) measurement during the inclusion period, without pre-existent HT, diabetes mellitus (DM) or atherosclerotic cardiovascular disease at time of study start. Study outcomes were a diagnosis of HT within one month after cohort entry and the use of antihypertensive medication within 4 months after cohort entry in HT diagnosed patients. We compared the incidence of outcomes between the age groups, stratified by systolic blood pressure (SBP). Logistic regression analysis was used to assess the influence of age-adjusted SBP Z-scores, age and gender on the outcomes. RESULTS: We included 19,500 patients from 159 GP's practices of whom 1,181 (6.1 %) were newly diagnosed with HT. Corrected for age-adjusted SBP, older patients were less likely to be diagnosed with HT (odds ratio per year age increase 0.98, p < 0.001). Corrected for age-adjusted SBP, no significant effect of age on the probability of treatment in newly diagnosed HT patients was observed (p = 0.82). CONCLUSIONS: This study showed that GPs are less inclined to diagnose HT with increasing patient age, but do not withhold treatment when they diagnose HT in older patients.
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Blok et al. (2016) conducted a cohort in Hypertension (n=19,500). Increasing age vs. Younger age was evaluated on Diagnosis of hypertension within one month after cohort entry (OR 0.98, 95% CI 0.97-0.99, p=<0.001). Increasing patient age was associated with a lower likelihood of being diagnosed with hypertension (OR 0.98 per year age increase), though age did not affect the probability of receiving treatment.
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