Hypertension control in the Tunisian elderly

Abstract

Background: Hypertension is a major public health problem. Despite therapeutic progress, blood pressure control remains insufficient particularly in the elderly. The aim of our study was to identify the factors associated with poor blood pressure control in the elderly in Tunisia. Material and methods: We conducted a descriptive study including 101 Tunisian treated hypertensive patients, aged 65 years and over, followed on an outpatient basis between November and December 2019. Results: Median age was 73 and sex ratio was 0.57. The major cardiovascular risk factor was diabetes in 60.4% of cases, followed by dyslipidaemia (48.5%) and smoking (40.6%). About 33% of the hypertensive patients realized regular physical activity and 31% had a high-sodium diet. Our patients were completely dependent in 4% of cases and among those aged 80 and over, 68.2% were frail. The prevalence of poor blood pressure control was 59%. Adherence to treatment was satisfactory in 75.2% of cases. In multivariate analysis, the factors associated with poor blood pressure control were: non-compliance with treatment [odds ratio (OR) = 0.19; p = 0.013], frailty (OR = 7.194; p = 0.004), the number of antihypertensive tablets (OR = 0.382; p = 0.008), non-use of thiazide diuretics (OR = 25.903; p = 0.001) and the patient's lack of knowledge of antihypertensive treatment (OR = 0.56; p = 0.008). Conclusion: Detection of the risk of non-compliance, the use of combined treatments screening for frailty and informing the patient about his/her treatment are necessary to improve blood pressure control in our Tunisian context.