Hierarchical linear and logistic modeling of outcomes of antihypertensive treatment in elderly patients

Findings from the PREVIEW study

Ivo Abraham, Lynnette Demosthenes, Karen MacDonald, Christopher Lee, Sally Reel, Heidi Brié, Christine Hermans, Stefaan Vancayzeele, Patricia Van der Niepen

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Achieving guideline-recommended blood pressure targets is difficult in older adults with hypertension. We completed a subgroup analysis of patients 65 years of age or older enrolled in PREVIEW, a prospective, multicenter, pharmacoepidemiological study of the determinants and outcomes of second-line antihypertensive treatment with valsartan in Belgium. Multilevel modeling was used to identify physician- and patient-level determinants of blood pressure values and practice guideline-derived definitions of blood pressure control. Data on 1560 patients and 504 physicians were used in this analysis. Blood pressure control rates for patients age 65 and over were lower for systolic (34.2% vs. 38.6%) and combined systolic/diastolic blood pressure (31.2% vs. 34.4%) compared to the entire PREVIEW sample. Twenty-seven percent of the variability in systolic, and 32% in diastolic pressure after 90 days of treatment were attributable to such variables as physicians' knowledge and adherence to evidence-based guidelines, practice patterns, and experience; with the remaining variance attributable to various demographic, behavioral, and clinical patient-related factors. Several independent predictors of uncontrolled blood pressure after 90 days of treatment were identified, largely confirming factors identified as determinants of blood pressure values. Recommendations for managing hypertension in the elderly are made in view of these findings.

Original languageEnglish (US)
Pages (from-to)45-53
Number of pages9
JournalArchives of Gerontology and Geriatrics
Volume51
Issue number1
DOIs
StatePublished - Jul 2010
Externally publishedYes

Fingerprint

Antihypertensive Agents
logistics
physician
hypertension
determinants
Blood Pressure
Belgium
Values
Valsartan
Physicians
Guidelines
Hypertension
evidence
experience
Evidence-Based Practice
Practice Guidelines
Multicenter Studies
Therapeutics
Demography

Keywords

  • Angiotensin II receptor blocker
  • Effectiveness of antihypertensive treatment with valsartan
  • Outcomes of antihypertensive treatment with valsartan
  • Pharmacoepidemiology in elderly

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology
  • Health(social science)
  • Gerontology

Cite this

Hierarchical linear and logistic modeling of outcomes of antihypertensive treatment in elderly patients : Findings from the PREVIEW study. / Abraham, Ivo; Demosthenes, Lynnette; MacDonald, Karen; Lee, Christopher; Reel, Sally; Brié, Heidi; Hermans, Christine; Vancayzeele, Stefaan; Van der Niepen, Patricia.

In: Archives of Gerontology and Geriatrics, Vol. 51, No. 1, 07.2010, p. 45-53.

Research output: Contribution to journalArticle

Abraham, I, Demosthenes, L, MacDonald, K, Lee, C, Reel, S, Brié, H, Hermans, C, Vancayzeele, S & Van der Niepen, P 2010, 'Hierarchical linear and logistic modeling of outcomes of antihypertensive treatment in elderly patients: Findings from the PREVIEW study', Archives of Gerontology and Geriatrics, vol. 51, no. 1, pp. 45-53. https://doi.org/10.1016/j.archger.2009.07.009
Abraham, Ivo ; Demosthenes, Lynnette ; MacDonald, Karen ; Lee, Christopher ; Reel, Sally ; Brié, Heidi ; Hermans, Christine ; Vancayzeele, Stefaan ; Van der Niepen, Patricia. / Hierarchical linear and logistic modeling of outcomes of antihypertensive treatment in elderly patients : Findings from the PREVIEW study. In: Archives of Gerontology and Geriatrics. 2010 ; Vol. 51, No. 1. pp. 45-53.
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