Trends in hypertension management and control among older adults in Germany 2008-2011 to 2022-2023

Abstract Background Management of hypertension is a public health concern due to its strong association with cardiovascular events. Recently, after decades of progress, hypertension treatment and control in high income countries has been observed to plateau. Trends of hypertension management in the growing ageing population are of special interest, but data are scare. We compare a German representative population-based examination survey 15 years ago with current data. Methods Blood pressure (BP) measurements, medication intake, and self-reported diagnoses in 66- to 79-year-olds are available from the German Health and Examination Survey for Adults (DEGS1) 2008-2011 and the study Gesundheit 65+ 2022-2023. A calibration formula accounted for the change in BP device (DEGS1: Datascope Accutorr Plus; Gesundheit 65+: Mobil-O-Graph). Definitions were: HYPERTENSIVE BP: ⩾140/90 mmHg; TREATMENT: use of antihypertensives among participants with hypertension diagnosis; HYPERTENSION: hypertensive BP or treatment; CONTROL: BP < 140/90 mmHg in treated participants. We report weighted statistics. Results Of 1,730 DEGS1 and 664 Gesundheit 65+ participants, 60% (n = 1,041) and 52% (n = 343), respectively, had hypertension and were under treatment. In 2008-2011, diuretics (55%) alongside beta-blockers (54%) were the most commonly used antihypertensives among treated participants with hypertension. 15 years later, the use of diuretics significantly declined to 42%. The most frequently used antihypertensives in Gesundheit 65+ were angiotensin receptor blockers (49%) and beta-blockers (49%). From 2008-2011 to 2022-2023, control of BP did not change significantly (69% to 64%), also not within medication classes. Conclusions Our trend analysis of hypertension management and control among older people in Germany shows changes in classes of medication intake, but not BP control. These results confirm the recent plateau in control of BP also for older adults, contrasting the earlier trend. Key messages • Two of three older adults in Germany with treated hypertension achieve BP control. • In the last 15 years, control of BP in older adults in Germany with treated hypertension remained unchanged.