PREVALENCE, AWARENESS, TREATMENT AND CONTROL OF HYPERTENSION IN A POPULATION OVER THE AGE OF 65 YEARS - RESULTS FROM THE STARNBERG STUDY ONEPIDEMIOLOGY OF PARKINSONISM AND HYPERTENSION IN THE ELDERLY (STEPHY)

Objective: To assess the prevalence of hypertension and isolated systo lic hypertension and the level of awareness, treatment and control of hypertension, in a population aged over 65 years. Design: Cross-sectio nal survey of the total population aged greater than or equal to 65 ye ars of two Bavarian villages with a representative age distribution. P atients: From a total of 1190 inhabitants aged greater than or equal t o 65 years, 982 (394 male, 588 female) participated (response rate 82. 5%). Methods: All of the participants were visited at home by physicia n observers. After a standardized questionnaire, blood pressure was me asured three times on one occasion with the subject in the sitting pos ition, using a standard mercury sphygmomanometer. 'Actual' hypertensio n was defined as systolic blood pressure (SBP) greater than or equal t o 160 or diastolic blood pressure (DBP) greater than or equal to 95 mm Hg, or both, or current use of antihypertensive drugs given for the in dication hypertension in patients with blood pressure <160/95 mmHg. Is olated systolic hypertension was defined as SBP greater than or equal to 160 and DBP <90 mmHg. All 'actual' hypertensives were further class ified as 'unaware' of hypertension, 'aware' (but not treated),'treated ' (current use of antihypertensive drugs for the indication hypertensi on and blood pressure greater than or equal to 160/95 mmHg) or 'contro lled' (treated and blood pressure <160/95 mmHg). Results: Mean +/- SD blood pressure was 154.5 +/- 24.4/84.9 +/- 11.6 mmHg (when 52 institut ionalized participants were excluded, 155.6 +/- 24.4/85.3 +/- 11.6 mmH g). The SBP was significantly higher in females than in males and incr eased up to the age group 80-84 years both in males and in females. Th e DBP decreased with age. The prevalence of 'actual' hypertension was 53% and increased up to the age group 75-79 years in males and 80-84 y ears in females. The prevalence of isolated systolic hypertension was 17% (with patients currently using antihypertensive drugs excluded). O f the patients with 'actual' hypertension, 34% were 'unaware' of the d iagnosis, 12% 'aware', 32% 'treated' and 22% 'controlled'. Conclusions : In central Europe hypertension, with a prevalence of >50%, remains t he most common cardiovascular risk factor in the elderly. Although mos t elderly hypertensives are currently treated with antihypertensive ag ents, less than one-quarter are controlled, and more than one-third ar e still unaware of the diagnosis. These levels of awareness and contro l call for better strategies in the diagnosis and treatment of hyperte nsion in the elderly.