The average age of the patients across the studies was 82, with most (71%) being female. The population had a high APO866 burden of comorbidity, with 32% experiencing falls, 39% dementia, 25% coronary heart disease, 28% cerebrovascular disease, and 23% diabetes mellitus. The prevalence of hypertension in care home residents as reported by these studies varied between a minimum of 16%24 and a maximum of 71%.17, 18 and 22 The mean prevalence of hypertension across the

studies was 35% (SD 18.4%). The prevalence increased over time, when later studies and earlier studies were compared, the lowest estimate being 16% in 199124 and the highest being 71% in 201022 (correlation coefficient: 0.682, AZD0530 P = .004). Of the 9 studies11, 12, 13, 14, 16, 17, 18, 19 and 22 that reported details of treatment, between 70% and 100% of their participants were on at least one antihypertensive agent. Combined across all the studies, a mean of 72% were on at least one antihypertensive agent. Overall, diuretics (27%, range 24%–66%), calcium channel blockers (26%, range 18%–30%), and angiotensin-converting enzyme inhibitors/angiotensin

receptor blockers (ACEi/ARBs) (24.6%, range 22%–65%) were most commonly used, whereas β-blockers were less commonly used (10.8%, range 8%–75%). A higher proportion of the hypertensive care home population took ACEi/ARBs (correlation coefficient: 0.875, R2 = 0.736, P = .001) and β-blockers (correlation

coefficient: 0.654, R2 = 0.427, P = .04) in later studies than in earlier studies, whereas the use of calcium channel blockers and diuretics remained static over time. There was a significant increase in the number of antihypertensive classes prescribed, when older studies were compared with more recent studies, from an average of 1.1 in 1994 to 2.0 in 2007 (correlation coefficient: 0.770, P = .025), with the median increasing CYTH4 from 1 in 1994 to 2 in 2010. When results from these studies were combined, 70% of those with hypertension had blood pressure readings within the target range. This compared to figures of 49% on treatment in the US population (1994) with 22% reaching target blood pressures26 and 63% on treatment with 27% reaching target levels as recorded in the National Health and Nutrition Examination Survey (NHANES) database 1999–2000.27 Blood pressure control was no better in recent studies compared with older studies, and there is a trend toward poorer control over time (correlation coefficient: –0.671, R2 = 0.450, P = .099). The review demonstrated that hypertension is common in care home residents and is often treated. The prevalence of hypertension is higher in later studies than in earlier studies. The number of antihypertensive classes used per patient increased over time and the classes of antihypertensives used differed in more recent studies compared with older studies.