Investigation of comprehensive intervention of hypertension in elderly outpatients

Objective To investigate the comprehensive intervention of hypertension in elderly outpatients. Methods From September to October 2010,533 elderly outpatients with hypertension were enrolled in this research. Each patient was invited to receive a set of standardized questionnaire, physical examination, laboratory tests and case history examination. Results (1) Totally 67.54% of patients were complicated with cardiovascular disease, chronic kidney disease or diabetes. (2) All patients completed laboratory tests relevant to hypertension. 22.89% and 19.89% patients were evaluated respectively on blood pressure(BP) grade and cardiovascular risk stratification. (3) Most of patients received the education about non-drug therapy, and the frequency of education was not high. (4) The rate of treatment and control of hypertension was 82.36% and 62.85% respectively. Compared with middle-risk patients, high-risk patients had higher treatment rate (76.66% vs 84.59%, P0.05), but significantly lower control rate(78.00% vs 56.91%,P0.01). 69.47% of the patients took ACEI or ARB. The level of LDL-C in 51.40% of the patients with high risk and in 31.42% with very high risk was controlled, and the rate of statin use in the two groups was 26.99% and 32.85% respectively. (5) The patients using aspirin accounted for 61.96% in secondary and 42.85% in primary prevention. (6) The level of HbA1c in 96.07% of the patients with diabetes was controlled under 7.5%. Conclusions The majority of elderly outpatients with hypertension are not evaluated on cardiovascular risk stratification. Comprehensive intervention including education of non-drug therapy, antihypertension, lipid control, anti-platelet, glucose control, especially the use of statin and aspirin is not sufficient. Clinical doctors should learn more about the guideline so as to strengthen comprehensive intervention.