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Abstract
Objectives
1. To determine if there are differences in the classes of antihypertensive agents prescribed for the elderly population as compared with younger patients. 2. To compare patterns of antihypertensive therapy with established national guidelines.
Design
National Ambulatory Medical Care Survey (NAMCS) database analysis from 1995–2000.
Setting
Multiple outpatient clinic settings in the US.
Participants
Primary care and sub-specialty physicians and their patients.
Measurements
332 510 280 outpatient visits with an ICD-9 code corresponding to a diagnosis of hypertension were analyzed. The class(es) of antihypertensive medications that patients were already taking and/or those added in that visit were noted. Demographics of the patients were also analyzed.
Results
There was a statistically significant association between the prescription of diuretics, calcium-channel blockers (CCBs), alpha-1-blockers (A1Bs), alpha-2 agonists (A2Ags) and age ≥65 years.
Conclusion
Patients aged 65 and over were prescribed different types of medications than those under age 65. Increased usage of diuretics and CCBs were in accordance with evidence-based guidelines for this group. A1Bs were likely used more due to co-morbid benign prostatic hyperplasia (BPH), but this is not certain. The increased prescription of A2Ags likely reflects long-term usage of these medications, which nonetheless may be hazardous due to their potential for causing increased cognitive dysfunction in the aged.
Acknowledgements
This research was supported by the Primary Care Research Unit, University of Colorado Health Sciences Center, Denver Colorado and HRSA Administrative Unit Grant #HP00054 5 D12. The authors wish to thank Matthew Huebschmann for his technical support in preparing the manuscript. Financial Arrangements with companies: None for any author. Financial support for this research: None for any author. The support from the Primary Care Research Unit was used to finance costs of accessing the NAMCS database and the services of Caroline Bublitz for research analysis. Consultations or speakers’ forums: None for any author. Company holdings or stocks: None for any author. This information was presented in abstract form at the Society of General Internal Medicine meeting in Vancouver, BC on May 1, 2003.