Hypertension Control for Seniors at Health Centers
Rachel Logan, MPH
Hypertension Deaths per 100,000 among all Adults 65+ in U.S., 2008-2010
Approximately 67 million people have high blood pressure in the U.S. Nearly two-thirds of those living with hypertensive conditions are aged 65 or older. High blood pressure, also known as hypertension and the “silent killer” can be controlled through good nutrition, an active lifestyle, tobacco cessation and medication if necessary.
Having uncontrolled high blood pressure increases the likelihood of suffering from a heart attack or stroke. Older adults may be able to control their high blood pressure without the use of medication, but are usually more likely to need medication than younger populations. High blood pressure in older adult populations is often associated with other comorbid conditions (i.e., multiple chronic conditions) such as diabetes, obesity and high cholesterol.
In the past years, seniors have been able to manage their high blood pressure better (see chart below). Health centers should plan to continue high blood pressure management efforts due to the expected growth of the senior population. In addition, diversity among seniors has increased with the influx of Hispanic and migrant seniors. Therefore, it is important for health centers to assess the needs of their senior populations and address the influence of cultural and linguistic differences in their hypertension control program.
Percentage of People with Controlled High Blood Pressure, 65+
Designing Your Management Program
The Million Hearts® Initiative advises that health care providers develop a Hypertension Treatment Protocol. Health centers have developed innovative methods to help seniors control their high blood pressure and should include such strategies in their protocol. The purpose of developing a protocol is to increase use of standard health practices throughout the entire organization. Protocols may include:
- Case management
- Behavioral interventions
 Office of the Assistant Secretary for Planning and Evaluation. 2012. Health System Measurement Project. Available at https://healthmeasures.aspe.hhs.gov/measure/20#Income-Level
 Centers for Disease Control. 2013. High Blood Pressure Fact Sheet. Division for Heart Disease and Stroke Prevention. Available at http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_bloodpressure.htm
 McDonald, M., Hertz, R., Unger, A., Lustik, M. (2009). Prevalence, Awareness, and Management of Hypertension, Dyslipidemia, and Diabetes among U.S. Adults Aged 65 and Older. Journal of Gerontology Series A: Biological Sciences and Medical Sciences. 64A(2):256-263. Available at http://www.ncbi.nlm.nih.gov/pubmed/19181717
 Centers for Disease Control. 2013. High Blood Pressure. Available at http://www.cdc.gov/bloodpressure/what_you_can_do.htm