Age and gender as risk factors
The study revealed that age and gender were significant risk factors for mortality in elderly hypertensive patients. The older the patients were, the higher their risk of death. The study also found that male patients had a higher mortality rate than female patients, which is consistent with previous studies. The authors suggested that the possible reasons for this gender difference could be the higher prevalence of smoking, alcohol consumption, and cardiovascular diseases among men, as well as the protective effects of estrogen in women.
Comorbidities and complications
The study also showed that comorbidities and complications were important predictors of mortality in elderly hypertensive patients. The most common comorbidities in the study population were diabetes mellitus, coronary artery disease, chronic kidney disease, and stroke. The study found that the presence of any comorbidity increased the risk of death by 2.5 times, and that the risk increased with the number of comorbidities. The study also reported that the most common complications of hypertension were heart failure, ischemic heart disease, and cerebrovascular accidents. The study found that the presence of any complication increased the risk of death by 3.6 times, and that the risk increased with the number of complications.
Blood pressure control and medication adherence
The study further demonstrated that blood pressure control and medication adherence were crucial factors for reducing mortality in elderly hypertensive patients. The study defined blood pressure control as having a systolic blood pressure of less than 140 mmHg and a diastolic blood pressure of less than 90 mmHg. The study found that only 38.9% of the patients achieved blood pressure control, and that those who did had a lower mortality rate than those who did not. The study also assessed medication adherence using the Morisky Medication Adherence Scale, which is a self-reported questionnaire that measures the frequency of forgetting, skipping, or stopping medication. The study found that only 34.6% of the patients had high medication adherence, and that those who did had a lower mortality rate than those who did not.
Implications and recommendations
The study concluded that hypertension is a major cause of mortality in elderly people, and that several factors, such as age, gender, comorbidities, blood pressure control, and medication adherence, can influence the outcome. The study suggested that early detection and treatment of hypertension, as well as regular monitoring and follow-up, are essential for improving the survival and quality of life of elderly hypertensive patients. The study also recommended that health care providers should educate and counsel the patients about the importance of medication adherence and lifestyle modifications, such as reducing salt intake, increasing physical activity, quitting smoking, and limiting alcohol consumption.
The study is one of the few studies that have focused on the factors affecting mortality in elderly hypertensive patients in India, where the prevalence of hypertension is high and the health care system is challenged by limited resources and accessibility. The study provides valuable insights and evidence for developing and implementing effective strategies and interventions for managing hypertension and preventing its complications and consequences in the elderly population.