The prevalence and treatment of hypertension in long-term care settings: Implications for quality of care of the frail elderly

This article reviews findings regarding the prevalence of hypertension and correlates of treatment among older nursing home residents and presents comparable data for a large sample of chronic hospital patients in the province of Ontario, Canada. Data from both populations suggest that those most vulnerable to potential undertreatment may include the very elderly, women, and those with cognitive and/or functional limitations. Low-dose thiazide diuretics appear to represent the preferred antihypertensive therapy for the frail elderly in long-term care. However, alternative therapy may be warranted for those who have a contraindication or are at greatest risk for experiencing adverse effects from diuretic therapy. Further research is needed to examine the relative benefits and risks of antihypertensive treatment in long-term care settings.