Prevalence, treatment, and control of hypertension in residents of skilled nursing facilities.

OBJECTIVE

To determine the prevalence, treatment, and control of hypertension (HTN) in elderly residents of skilled nursing facilities (SNFs). To determine variables that may influence the treatment and control of HTN in residents of SNFs.

DESIGN

Concurrent medical record review of SNF residents who had resided at a facility for a minimum of 30 days.

SETTING

Twelve SNFs in western Iowa and eastern Nebraska.

PARTICIPANTS

All residents studied were living in one of the 12 SNFs, N=966.

MAIN OUTCOME MEASURE(S): Data collected from each medical record included: demographic characteristics, past medical history, blood pressure (BP) taken over the preceding 30 days, and antihypertensive medications and their doses. The BP reading used to define BP control, or lack thereof, was based on the last recorded BP measurement in the medical record.

RESULTS

The total percentage of patients with HTN was 77%. Of those with HTN, 71% had controlled BP and 29% had uncontrolled BP. The average number of antihypertensive drugs used was not significantly different between patients with controlled and uncontrolled BP. Multivariate analysis failed to identify any patient demographic characteristic or comorbidity that correlated with a higher rate of BP control. The number of antihypertensive drugs administered correlated significantly with BP control. The specific type of antihypertensive drug or drug combination did not correlate with BP control. Patients with controlled BP were significantly more likely to be receiving antihypertensive therapy at higher doses than patients with uncontrolled BP.