HYPERTENSION IN NURSING-HOME PATIENTS

There have been few studies of hypertension in nursing home patients. To assess the prevalence, demographic characteristics, comorbidity and drug therapy in hypertensive nursing home patients compared with thos e who are normotensive, we reviewed all medical charts of patients in three nursing home facilities. Of the 804 patients, 355 (44.2%) have h ypertension. Calcium channel blockers were the most frequently prescri bed anti-hypertensive (30.3%) and together with diuretics (28.4%) and ACE inhibitors (27.7%) account for more than 85%. Hypertensive patient s take more cardiac, hypoglycaemic, and analgesic drugs (P = < 0.001, < 0.001, and 0.004, respectively) than those who are normotensive. Ove rall patients take an average of 8.68 medications daily. In hypertensi ve patients, the average number of comorbid conditions (excluding hype rtension) is 5.02 compared with 3.23 in normotensive patients. Hyperte nsion is significantly associated with diabetes, heart disease, cerebr ovascular disease, neoplasms, endocrine disorders, gastrointestinal di seases, psychiatric disorders, dementia, other central nervous system diseases, skin problems, blood diseases and inversely with hip fractur e. Blood pressure control (< 140/90 mmHg) is achieved in 88.8%, is not related to age and is significantly more frequent in males than femal es (91.8% vs 82.6% P = 0.025). The problem of hypertension in nursing home patients is complex and has received insufficient study. Since st udies demonstrating benefit from anti-hypertensive therapy in the elde rly excluded the very elderly and those with significant comorbid cond itions, additional research is needed.