Prevalence, awareness, treatment and control of arterial hypertension in an elderly population in Belgium

Objective: To study the prevalence, awareness, treatment and control of arterial hypertension in the elderly population in Belgium. Study group: An age- and sex-stratified sample of 2212 Belgian subjects aged 65 years or more, selected from the original cohort of the Belgian Interuniversity Research on Nutrition and Health (BIRNH) study; participation in this follow-up study was 72.6%. Methods: Blood pressure (BP) was measured at home by trained technicians using a standard protocol. Isolated systolic hypertension (ISH) was defined as a systolic BP ≥ 160 mmHg and a diastolic BP < 95 mmHg. Diastolic hypertension was defined as a diastolic BP ≥ 95 mmHg. The total hypertensive population was defined as all those with ISH, diastolic hypertension and with BPs < 160-95 mmHg but currently taking antihypertensive drugs. Awareness and treatment status were investigated through a structured interview. Results: The prevalence of arterial hypertension was 43.9%, higher in women than in men and increasing with age in women; elevated BP was found in 22.3 to 28.6% of the participants varying by age and sex. In the > 75-year-old subjects this elevation was in two-thirds of the cases due to ISH; 84% of all female hypertensives were aware of the condition compared to 68% in men. Treatment advice had been given in a majority of the aware subjects and two-thirds of all treated persons was under control. Among a variety of independent variables and besides the gender difference, awareness was only related to smoking and to depression while control differed by region of residence. Conclusion: Arterial hypertension is highly prevalent in this elderly population; awareness and BP control are within acceptable ranges but there is still room for improvement, particularly in elderly men.