Hypertension Treatment and Control in Older Adult at Tanjung Sari Primary Health Care

Rahmi Fauziah; Enny Rohmawaty; Lazuardhi Dwipa

Hypertension Treatment and Control in Older Adult at Tanjung Sari Primary Health Care

Rahmi Fauziah, Enny Rohmawaty, Lazuardhi Dwipa

Abstract

Background: Hypertension is considered as a major health problem in Indonesia, especially in older adult population because of its prevalence increases by age. Treatment strategy and control management of hypertension in Public Health Center (Pusat Kesehatan Masyarakat, Puskesmas) as primary health care should be enhanced to overcome this issue. This study aimed to describe the pattern of antihypertensive agent in older adults.

Methods: This was a descriptive study with total sampling method for data collection. Data were collected from medical record of older adult patients with diagnosis of hypertension at Puskesmas Tanjung Sari from January to December 2013. The variables observed were gender, number of visits, the degree of hypertension, types of antihypertensive drug, combinations of antihypertensive drugs, and blood pressure control.

Results: The number of older adults with hypertension was 180 people. Some of which, 120 women (66.7%) participated, 152 (84.4%) had hypertension stage 2, 100 (55.6%) had just one visit, and 80 (44.4%) had more than one visit. Among 80 participants with more than one visit, 8 had achieved target blood pressure. There were 166 participants (92.2%) who received single antihypertensive agent (captopril was given the most), and 14 participants (7.8%) who received the combination of two antihypertensive agent (combination of captopril and HCT (hydrochlorothiazide)) were given the most).

Conclusions: More than 75% of older adult with hypertension have stage 2 hypertension and are treated by single antihypertensive agent. Ninety percent of the patient have uncontrolled blood pressure. [AMJ.2016;3(1):17–21]

DOI: 10.15850/amj.v3n1.699

Keywords

Antihypertensive agent, hypertension, older adult, Puskesmas

Full Text:

PDF

References

Departement of Economic and Social Affairs. Population ageing and development 2012. New York: United Nations; 2012.

Pusat Data dan Informasi. Buletin lansia. Jakarta: Departemen Kesehatan Republik Indonesia; 2013.

Lawes CM, Hoorn SV, Rodgers A. Global burden of blood pressure related disease, 2001. Lancet. 2008;371(9623):1513–8.

Rahajeng E, Tuminah S. Prevalence of hypertension and its determinants in Indonesia. IDNMED. 2009;59(12):580–7.

Departemen Kesehatan Republik Indonesia. Masalah hipertensi di Indonesia. Jakarta: 2012 [cited 2014 March 2]; Available from: http://www.depkes.go.id/article/view/1909/masalah-hipertensi-di-indonesia.html.

Shi S, Mörike K, Klotz U. The clinical implications of ageing for rational drug therapy. Eur J Clin Pharmacol. 2008;64(2):183–99.

Hilmer SN, McLachlan AJ, Le Couteur DG. Clinical pharmacology in the geriatric patient. Fund Clin Pharmacol. 2007;21(3):217–30.

McLean AJ, Le Couteur DG. Aging biology and geriatric clinical pharmacology. Pharmacol Rev. 2004;56(2):163–84.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289(19):2560–71.

Krause T, Lovibond K, Caulfield M, McCormack T, Williams B. Management of hypertension: summary of NICE guidance. BMJ. 2011;343:d4891.

Coylewright M, Reckelhoff JF, Ouyang P. Menopause and hypertension: an age-old debate. Hypertension. 2008;51(4):952–9.

Brindel P, Hanon O, Dartigues J-Fo, Ritchie K, Lacombe J-M, DucimetiÃ¨re P, et al. Prevalence, awareness, treatment, and control of hypertension in the elderly: the Three City study. J Hypertens. 2006;24(1):51–8.

Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(28):2159–219.

Aronow WS, Fleg JL, Pepine CJ, Artinian NT, Bakris G, Brown AS, et al. ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the american college of cardiology foundation task force on clinical expert consensus documents. JACC. 2011;57(20):2037–114.

Bramley TJ, Gerbino P, Nightengale B, Frech-Tamas F. Relationship of blood pressure control to adherence with antihypertensive monotherapy in 13 managed care organizations. JMCP. 2006;12(3):239–45.

Yiannakopoulou EC, Papadopulos JS, Cokkinos DV, Mountokalakis TD. Adherence to antihypertensive treatment: a critical factor for blood pressure control. Eur J Prev Cardiol. 2005;12(3):243–9.

Krousel-Wood M, Thomas S, Muntner P, Morisky D. Medication adherence: a key factor in achieving blood pressure control and good clinical outcomes in hypertensive patients. Curr Opin Cardiol. 2004;19(4):357–62.

Roumie CL, Elasy TA, Greevy R, Griffin MR, Liu X, Stone WJ, et al. Improving blood pressure control through provider education, provider alerts, and patient education: a cluster randomized trial. Ann Intern Med. 2006;145(3):165–75.

Baroletti S, Dell'Orfano H. Medication adherence in cardiovascular disease. Circulation. 2010;121(12):1455–8.