Arterial hypertension, antihypertensive therapy, and visit-to-visit blood pressure variability of elderly nursing home residents

Background and aim: Arterial hypertension is a common health problem in older nursing home residents (NHR). The aim of this study was to prospectively analyze blood pressure (BP) patterns, antihypertensive therapy, and visit-to-visit BP variability in NHR. Methods: BP, visit-to-visit variability (estimated by standard deviation of means) of systolic BP (SBP) were analyzed in 12 nursing homes in Germany. NHR who were at least 65 years old and had no moderate or severe dementia were studied at baseline (T0), after 3 and 6 months, respectively. Results: BP data were available for 177 NHR (mean age 83.8, 69.5% female) at T0. A total of 90.4% NHR was affected by hypertension. Mean systolic/diastolic blood pressure was 130,1/75,5mmHg. BP values of 140/90mmHg were found in 29.9%, while 33.9% of NHR exhibited SBP values <120mmHg. At least one antihypertensive drug was used in 84.2%, and 40.7% of NHR were treated with at least three different drugs. The median of the visit-to-visit SBP variability was 9.05 (Min. 0, Max. 35.78); an influence of age, sex, and type of antihypertensive medication was not found. Conclusion: Elderly German NHR showed a high prevalence of hypertension and BP was controlled in 80%. However, a large proportion received intensive BP lowering pharmacotherapy and exhibited SBP values clearly lower than recommend target values between 140 and 150mmHg particularly for elderly patients over 80 years. Thus, to avoid overtreatment BP should be monitored closely to adapt antihypertensive therapy in this population.