A T Cheong1, S G Sazlina2, S F Tong3, A S Azah4, S Salmiah5. 1. Cheong Ai Theng MMed (Fam Med) Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra, Malaysia, Serdang, 43400 Selangor, Malaysia. Email: caitheng@gmail.com. 2. Shariff-Ghazali Sazlina MMed (Fam Med), PhD Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400 Selangor, Malaysia. drsazsg@gmail.com. 3. Tong Seng Fah MMed (Fam Med), PhD Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Jalan Yaacob Latif, Cheras, 56000 Kuala Lumpur, Malaysia. Email: sengfahtong@gmail.com. 4. Abdul Samad Azah MMed (Fam Med) Klinik Kesihatan Tanglin, Jalan Cenderasari, 50590 Kuala Lumpur, Malaysia. Email: azahas@hotmail.com. 5. Sharif Salmiah MMed (Fam Med) Klinik Kesihatan Batu 9, 43200 Cheras, Hulu Langat, Selangor, Malaysia. Email: drmayasharif@yahoo.com.
Abstract
INTRODUCTION: Hypertension is highly prevalent in the older people. Chronic disease care is a major burden in the public primary care clinics in Malaysia. Good blood pressure (BP) control is needed to reduce the morbidity and mortality of cardiovascular disease (CVD). This study aimed to determine the status of BP control and its associated factors among older people with hypertension in public primary care clinics. MATERIALS AND METHODS: A cross-sectional study on hypertensive patients aged 18 years and above was conducted in six public primary care clinics in Federal Territory, Malaysia. A total of 1107 patients were selected via systematic random sampling. Data from 441 (39.8%) patients aged 60 years and more were used in this analysis. BP control was determined from the average of two BP readings measured twice at an interval of 5 min. For patients without diabetes, poor BP control was defined as BP of ≥140/90 mm Hg and ≥150/90 for the patients aged 80 years and more. For patients with diabetes, poor control was defined as BP of ≥140/80 mm Hg. RESULTS: A total of 51.7% (n = 228) of older patients had poor BP control. The factors associated with BP control were education level (p = 0.003), presence of comorbidities (p = 0.015), number of antihypertensive agents (p = 0.001) and number of total medications used (p = 0.002). Patients with lower education (less than secondary education) (OR = 1.7, p = 0.008) and the use of three or more antihypertensive agents (OR = 2.0, p = 0.020) were associated with poor BP control. CONCLUSION: Among older people with hypertension, those having lower education level, or using three or more antihypertensive agents would require more attention on their BP control.
INTRODUCTION:Hypertension is highly prevalent in the older people. Chronic disease care is a major burden in the public primary care clinics in Malaysia. Good blood pressure (BP) control is needed to reduce the morbidity and mortality of cardiovascular disease (CVD). This study aimed to determine the status of BP control and its associated factors among older people with hypertension in public primary care clinics. MATERIALS AND METHODS: A cross-sectional study on hypertensivepatients aged 18 years and above was conducted in six public primary care clinics in Federal Territory, Malaysia. A total of 1107 patients were selected via systematic random sampling. Data from 441 (39.8%) patients aged 60 years and more were used in this analysis. BP control was determined from the average of two BP readings measured twice at an interval of 5 min. For patients without diabetes, poor BP control was defined as BP of ≥140/90 mm Hg and ≥150/90 for the patients aged 80 years and more. For patients with diabetes, poor control was defined as BP of ≥140/80 mm Hg. RESULTS: A total of 51.7% (n = 228) of older patients had poor BP control. The factors associated with BP control were education level (p = 0.003), presence of comorbidities (p = 0.015), number of antihypertensive agents (p = 0.001) and number of total medications used (p = 0.002). Patients with lower education (less than secondary education) (OR = 1.7, p = 0.008) and the use of three or more antihypertensive agents (OR = 2.0, p = 0.020) were associated with poor BP control. CONCLUSION: Among older people with hypertension, those having lower education level, or using three or more antihypertensive agents would require more attention on their BP control.
Entities:
Keywords:
Blood pressure; Malaysia; hypertension; older people; primary care
Authors: Patricia M Kearney; Megan Whelton; Kristi Reynolds; Paul Muntner; Paul K Whelton; Jiang He Journal: Lancet Date: 2005 Jan 15-21 Impact factor: 79.321
Authors: Wilbert S Aronow; Jerome L Fleg; Carl J Pepine; Nancy T Artinian; George Bakris; Alan S Brown; Keith C Ferdinand; Mary Ann Forciea; William H Frishman; Cheryl Jaigobin; John B Kostis; Giuseppi Mancia; Suzanne Oparil; Eduardo Ortiz; Efrain Reisin; Michael W Rich; Douglas D Schocken; Michael A Weber; Deborah J Wesley Journal: J Am Coll Cardiol Date: 2011-04-26 Impact factor: 24.094
Authors: Ai Theng Cheong; Seng Fah Tong; Sharrif G Sazlina; Abdul Samad Azah; Md Sharif Salmiah Journal: Asia Pac J Public Health Date: 2013-03-27 Impact factor: 1.399
Authors: Aram V Chobanian; George L Bakris; Henry R Black; William C Cushman; Lee A Green; Joseph L Izzo; Daniel W Jones; Barry J Materson; Suzanne Oparil; Jackson T Wright; Edward J Roccella Journal: Hypertension Date: 2003-12-01 Impact factor: 10.190
Authors: K Matsumura; H Arima; M Tominaga; T Ohtsubo; T Sasaguri; K Fujii; M Fukuhara; K Uezono; Y Morinaga; Y Ohta; T Otonari; J Kawasaki; I Kato; T Tsuchihashi Journal: QJM Date: 2013-05-20
Authors: Giuseppe Mancia; Robert Fagard; Krzysztof Narkiewicz; Josep Redon; Alberto Zanchetti; Michael Böhm; Thierry Christiaens; Renata Cifkova; Guy De Backer; Anna Dominiczak; Maurizio Galderisi; Diederick E Grobbee; Tiny Jaarsma; Paulus Kirchhof; Sverre E Kjeldsen; Stéphane Laurent; Athanasios J Manolis; Peter M Nilsson; Luis Miguel Ruilope; Roland E Schmieder; Per Anton Sirnes; Peter Sleight; Margus Viigimaa; Bernard Waeber; Faiez Zannad; Josep Redon; Anna Dominiczak; Krzysztof Narkiewicz; Peter M Nilsson; Michel Burnier; Margus Viigimaa; Ettore Ambrosioni; Mark Caufield; Antonio Coca; Michael Hecht Olsen; Roland E Schmieder; Costas Tsioufis; Philippe van de Borne; Jose Luis Zamorano; Stephan Achenbach; Helmut Baumgartner; Jeroen J Bax; Héctor Bueno; Veronica Dean; Christi Deaton; Cetin Erol; Robert Fagard; Roberto Ferrari; David Hasdai; Arno W Hoes; Paulus Kirchhof; Juhani Knuuti; Philippe Kolh; Patrizio Lancellotti; Ales Linhart; Petros Nihoyannopoulos; Massimo F Piepoli; Piotr Ponikowski; Per Anton Sirnes; Juan Luis Tamargo; Michal Tendera; Adam Torbicki; William Wijns; Stephan Windecker; Denis L Clement; Antonio Coca; Thierry C Gillebert; Michal Tendera; Enrico Agabiti Rosei; Ettore Ambrosioni; Stefan D Anker; Johann Bauersachs; Jana Brguljan Hitij; Mark Caulfield; Marc De Buyzere; Sabina De Geest; Geneviève Anne Derumeaux; Serap Erdine; Csaba Farsang; Christian Funck-Brentano; Vjekoslav Gerc; Giuseppe Germano; Stephan Gielen; Herman Haller; Arno W Hoes; Jens Jordan; Thomas Kahan; Michel Komajda; Dragan Lovic; Heiko Mahrholdt; Michael Hecht Olsen; Jan Ostergren; Gianfranco Parati; Joep Perk; Jorge Polonia; Bogdan A Popescu; Zeljko Reiner; Lars Rydén; Yuriy Sirenko; Alice Stanton; Harry Struijker-Boudier; Costas Tsioufis; Philippe van de Borne; Charalambos Vlachopoulos; Massimo Volpe; David A Wood Journal: Eur Heart J Date: 2013-06-14 Impact factor: 29.983