ANTIHYPERTENSIVE MEDICATION USE AMONG RECRUITS FOR THE TRIAL OF NONPHARMACOLOGIC INTERVENTIONS IN THE ELDERLY (TONE)

OBJECTIVES: To examine the distribution and correlates of the classes of antihypertensive medications taken by persons aged 60 to 80. DESIGN : Cross-sectional screening. SETTING: Four academic medical centers in the southern and eastern United States. PARTICIPANTS: Volunteers (N = 2601) entering a clinical trial testing the value of nonpharmacologic approaches to control blood pressure who were either taking one or tw o (single or combined) medications for the treatment of hypertension a nd expressed willingness to be withdrawn from these medications accord ing to a standardized protocol MEASUREMENTS: Medication use, blood pre ssure, and data from self-administered questionnaires collected during standardized clinic visits. RESULTS: Calcium channel blockers (23.9%) were the most frequent single agent antihypertensive medications used by cohort members, followed by diuretics (17.9%) and angiotensin-conv erting enzyme (ACE) inhibitors (17.5%). The most common combination ag ents were composed of diuretics with either calcium channel blockers ( 5.4%), ACE inhibitors (4.0%), or beta-blockers (3.7%). Women were twic e as likely to be taking diuretics, and less likely to be taking ACE i nhibitors and beta-blockers, than men. Blacks were more likely to be t aking diuretics and calcium channel blockers, and less likely to be ta king beta-blockers and ACE inhibitors, than others. These relationship s could not be attributed to differences in geographical area, other d emographic factors, age, or medical history. CONCLUSIONS: These usage patterns appear to mirror those in the population of the United States as a whole, which has trended toward greater usage of calcium channel blockers and ACE inhibitors with declining use of diuretics. The dist ribution of antihypertensive medications among older hypertensives is markedly different between women and men and between black Americans a nd others.