Elderly hypertensive patients missing out on lifestyle modification advice

8 November 2007

MedWire News: Patients with hypertension older than 60 years are less likely than younger hypertensive patients to receive lifestyle modification advice from their physicians, US researchers report.

In contrast, overweight or obese hypertensive individuals and those receiving antihypertensive medication are more likely to receive lifestyle modification advice than other patient groups.

"Lifestyle modification advice should certainly not be abandoned in older hypertensive patients," Anthony Viera and colleagues from the University of North Carolina at Chapel Hill write in the Journal of Clinical Hypertension.

Viera and team analyzed data from an ongoing telephone survey administered by the Centers for Disease Control and Prevention to determine the prevalence of lifestyle modification advice received by 28,457 adults with hypertension.

Overall, 90.3% of the participants reported receiving some type of advice. Of these, 74.6% reported receiving exercise advice, 69.3% were advised to reduce salt intake, 61.9% were told to change their eating habits, and 43.5% were advised to reduce alcohol intake.

However, analysis of subgroups of patients revealed that individuals aged 18-39 or 40-59 years were more likely to receive lifestyle modification advice than those aged 60 years or older (odds ratios [OR]=1.42 and 1.45, respectively).

In particular, only 53.7% of those aged 60 years or older reported receiving eating habit advice, compared with 71.2% and 64.9% of those aged 40-59 or 18-39 years, respectively (p<0.001). Similarly, the corresponding percentages of participants advised to reduce alcohol intake were 35.1% versus 43.3% and 48.9%.

Overweight and obese patients were more likely than underweight or normal-weight individuals to receive lifestyle modification advice (ORs=1.64 and 2.75, respectively).

Patients currently taking antihypertensive medication were also more likely than those who were not treated for hypertension to receive lifestyle medication advice (OR=2.35)

Viera told MedWire News: "It is important for both physicians and patients to remember that lifestyle changes - such as eating healthier, exercising, and reducing salt - are part of the management of all people with hypertension."

He added: "Involving patients in their hypertension care is important. All of hypertension care really comes down to lifestyle change. Even the decision to follow a doctor's advice to take a medication is a lifestyle change."

J Clin Hypertens 2007; 9: 850-858