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Hypertension management in the elderly has been heavily criticised by new research finding the disease is adequately controlled in only a fifth of patients over 65.

The researchers said hypertension control was 'still poor' and echoed recent calls for greater use of polypharmacy after finding more than half

of patients were on just one drug.

The study found 80 per cent of 4,582 elderly patients had hypertension, but only 23 per cent of men and 18 per cent of hypertensive women had controlled blood pressure below the NICE target of 140/90mmHg.

More than 40 per cent of hypertensives had received no treatment for their disease, according to the study, presented at the British Hypertension Society's annual scientific meeting earlier this month.

Study leader Professor Neil Poulter, professor of preventive cardiovascular medicine at University College London and chair of the BHS, said: 'Control of hypertension is still poor among elderly patients and coexistent cardiovascular risk factors including diabetes did not result in a

better blood pressure control.'

Of those who were treated, 54 per cent were on mono-therapy, with only 35 per cent on two drugs and 11 per cent on three.

Professor Bryan Williams, professor of medicine at the University of Leicester and a member of the guideline committees for both NICE and the BHS, recently warned that GPs would not meet their

hypertension targets without greater use of polyphar-

macy (Pulse, September 13).

The new research found hypertension control improv-ed the more drugs that were used, from 32 per cent with one drug to 40 per cent with three or more.

A second study, in Family Practice (October), concluded there was 'a huge amount of work' to be done to meet national service framework targets for CHD after finding elderly patients were significantly undertreated.

Study leader Professor Shah Ebrahim, professor of epidemiology of ageing at the University of Bristol and a member of the CHD national service framework external reference group, said: 'We should not be defeatist but look at other ways to meet targets.'

By Brian Kelly

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