ABC | Volume 112, Nº3, March 2019

Original Article Sousa et al Prevalence of hypertension in older adults Arq Bras Cardiol. 2019; 112(3):271-278 Figure 1 – Flowchart of the assessed sample identifying normotensive and hypertensive participants; those undergoing treatment and the ones without treatment for hypertension; and with and without pressure control. Goiânia, Goiás, 2010. Total sample n = 912 (100%) Normotensive n = 229 (25.2%) Hypertensive n = 683 (74.9%) Undergoing treatment n = 496 (72.7%) No treatment n = 187 (27.3%) No pressure control n = 244 (49.2%) With pressure control n = 252 (50.8%) Multiple logistic regression analysis was used to estimate the independent effect of variables on outcomes such as AH prevalence, treatment and disease control. The variables that showed a p value < 0.20 in the bivariate analysis were tested in the multiple logistic regression models. All statistical tests were performed considering a level of significance of 5%. Results Of the 912 elderly, 683 (74.9%) were hypertensive, of which 72.6% were treated for AH and, among the treated ones, 50.8% had controlled BP (Figure 1). Of the total sample (n = 912), 62.1% were females. The mean age was 71.5 years (SD ± 8.3), and the median age was 70 years (Table 1). The AH prevalence was 74.9% (n = 683), of which 431 elderly individuals were identified as having BP ≥140 and/or 90 mmHg, whereas 252 elderly individuals had BP values within the normal range but used hypertensive medication. There was a difference in prevalence between genders, being 39.8% in men and 60.2% in women. The prevalence of isolated systolic hypertension (ISH) was 29.2% in total, with no difference between genders, being significantly higher in the age group of 70 to 80 years (112; 42.1%) when compared with the age group of 60 to 70 years (94; 35.3%), with a prevalence ratio of 1.75 (95%CI: 1.38–2.20). Lifestyle-related variables, such as smoking status, alcohol consumption, overweight/obesity, sedentary lifestyle, level of schooling, income and marital status showed no association with AH prevalence (Table 2). Of the 431 individuals who were identified as having altered BP levels, 187 (43.4%) were unaware of the probable AH diagnosis and were not being treated for the disease. Of the 683 patients considered hypertensive, 496 (72.6%) reported regular use of antihypertensive medication, with lower rates (67.6%) being observed in men when compared to women (75.9%) (Table 2). Among those who received treatment for the disease, 252 (50.8%) showed BP control (SBP/DBP < 140/90mmHg), also with a difference between genders; the control rates were higher among those aged 60 to 70 years (Table 2). As for alcohol consumption, there was an association with the control rate, with lower control rates being observed among those who consumed alcohol (Table 2). The multiple logistic regression analysis showed there was a significant association between the prevalence rate and the male gender, with a higher probability of AH (OR = 1.39, 95%CI 1.04‑1.92). Current smoker was associeted with the treatment rate (OR = 2.06, 95%CI: 1.28-3.33). Female gender (OR = 1.57, 1.19-2.08) and alcohol consumption (OR = 1.41, 95%CI 1.00-1.99) were associatedwith the control rate (Table 3). Discussion The present study analyzed the prevalence, treatment and control rates of AH in a representative sample of the urban elderly population in the city of Goiânia, Brazil. The prevalence of AH was 74.9%, higher than observed in the country’s adult population shown by other studies carried out in different regions. 8,11,12,19-21 The prevalence of AH in individuals aged between 50 and 70 years is approximately 6 to 8-fold higher than that in young adults, aged between 18 and 29 years, 19-22 consistent with 16 studies carried out in the country between 1989 and 2007, which reported prevalence rates of AH higher than 60% in the elderly population. 10 Similar prevalence rates were also shown in a study carried out in Poland, with lower values being observed in men (69.9%; 95%CI: 65.2–74.2) than in women (80.2%, 95%CI: 75.7–84.1), at the age range of 80 years old or older. The prevalence for Polish individuals older than 65 years (BP140/90 mmHg) was 78.2% (95%CI: 76.44–79.8) in women 273