Significant improvement in the treatment of hypertension in the elderly and the oldest-old during the last decade in poland - results of the polsenior surveys

Objective: The purpose of this study was to assess changes in the prevalence, detection and effectiveness of treatment of arterial hypertension (AH) over the past decade in people 65+ years of age in Poland. Design and method: The results from two national cross-sectional surveys that examined representative samples of Poland's elderly individuals were compared: PolSenior performed in 2008-2009 (n=4950, age range 65-104) and PolSenior2 in 2018-2019 (n=5057, age range 65-106). Blood pressure (BP) was measured by nurses during two separate visits at the subjects’ homes. During each visit, BP was measured three times using one of three cuffs depending on arm circumference to analysis average of the first and second measurements was used. AH was diagnosed when at each of the two visits the mean systolic blood pressure (SBP) was >=140mmHg and/or the mean diastolic blood pressure (DBP) was >=90mmHg or if the subject was taking antihypertensive medication for previously diagnosed AH. Results: In the last decade there was a significant reduction in SBP of 7.4mmHg in women [from 146.5mmHg (95%CI 144.6-148.5) to 139.1mmHg (95%CI 137.9-140.3)] and 6.9mmHg in men [from 146. 9mmHg (95%CI 145.5-148.3) to 140.0mmHg (95%CI 138.7-141.3)], and a DBP of 7.7mmHg in women [from 85.7mmHg (95%CI 84.8-86.6) to 78.0mmHg (95%CI 77.3-78.6)] and 4.0mmHg in men [from 83.2mmHg (95%CI 82.5-83.9) to 79.2 mmHg (95%CI 78.7-79.7)]. The prevalence of AH in people aged 65 and older remained unchanged over the analysed time period (78%). The percentage of those aware of AH has increased in the last decade in women from 79.6% to 84.6%, and in men from 70.2% to 78.1%. Among all AH patients, the percentage of those with good BP control (<140/90mmHg) increased in women from 25.1% to 35.3% and in men from 19.9% to 32.2%. Conclusions: In the last decade, significant improvement was achieved in the control of AH in seniors in Poland. The percentage of patients with well-controlled AH increased by almost 40% over the decade. The significant reduction in BP in the entire 65+ population and such a large increase in effectively treated hypertensives represent very positive changes.