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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access published online on January 30, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, doi:10.1093/gerona/gln016
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© 2009 The Authors.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Prevalence, Awareness, and Management of Hypertension, Dyslipidemia, and Diabetes Among United States Adults Aged 65 and Older

Margaret McDonald1, Robin P. Hertz1, Alan N. Unger1 and Michael B. Lustik2

1 Evidence-Based Strategies, Pfizer Inc., New York
2 Science Applications International Corporation, Reston, Virginia

Address correspondence to Margaret McDonald, PhD, Evidence-Based Strategies–Comparative Effectiveness and Population Studies, Pfizer Inc., 235 East 42nd Street, New York, NY 10017. Email: margaret.m.mcdonald{at}pfizer.com


  Abstract

Background.: Adults aged 65 and older are disproportionately affected by hypertension, dyslipidemia, and diabetes, which are established risk factors for cardiovascular disease (CVD). Although risk reduction strategies among older adults, including control of CVD risk factors, can lead to a decline in premature CVD morbidity and mortality, the prevalence of these risk factors has generally increased in the past decade among elders and risk factor control rates have been suboptimal. We assess prevalence, awareness, treatment, and control rates among U.S. adults aged 65 and older with respect to hypertension, dyslipidemia, and diabetes and describe predictors associated with awareness and management of these factors.

Methods.: Analysis of nationally representative data collected from adults aged 65 and older (n = 3,810) participating in the National Health and Nutrition Examination Survey 1999–2004.

Results.: Women have a significantly higher prevalence of hypertension than men (76.6% vs 63.0%) and a significantly lower rate of control when treated pharmacologically (42.9% vs 57.9%). Dyslipidemia prevalence is 60.3% overall, and women are significantly more likely to be aware of their condition than men (71.1% vs 59.1%). Diabetes affects 21.2% of older adults, and 50.9% of prevalent cases are treated pharmacologically. Goal attainment among those treated is problematic for all three conditions—hypertension (48.8%), dyslipidemia (64.9%), and diabetes (50.4%). Having two or more doctor visits annually is associated with goal attainment for dyslipidemia.

Conclusions.: Knowledge of cardiovascular health in older adults and understanding gender gaps in awareness can help physicians and policymakers improve disease management and patient education programs.

Keywords Hypertension; High cholestrol; Diabetes; Prevalance; Older adults

Received: December 18, 2007; Accepted: April 3, 2008

Decision Editor: Luigi Ferrucci, MD, PhD


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