P-583: A model for improving blood pressure control in elderly hypertensive patients: The Lifestyle University project

• Published in: American journal of hypertension Vol. 18; no. S4; p. 220A
• Main Authors: Hajjar, Ihab M., Frost, Brandy K., Blackledge, Jennifer L.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.05.2005
• Subjects: Lifestyle Intervention for Hypertension Control; Multi-Disciplinary Approach to Hypertension; Older Adults and Hypertension
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1016/j.amjhyper.2005.03.600

Elderly hypertensive patients have the poorest rate of blood pressure control in the US. Multiple patient, physician, and system related factors have been implicated in the underlying cause, such as poor access to healthcare, unhealthy lifestyle habits, suboptimal physician-patient interaction, poor disease education and health disparities. We address these factors through a “group-education” format, the Lifestyle University (LU) through the Center for Senior Hypertension (CSH). “Faculty” included a cardiovascular dietician, an exercise specialist, a geriatric pharmacist, a stress-management specialist, a geriatric social worker, and a geriatric-hypertension specialist. We identified patients with poorly controlled hypertension and poor lifestyle through our community outreach program, which partnered with faith-based organizations, barbers and beauticians, and senior residential communities. To date, we have screened 139 patients (Age range: 24–87, 88 Females, 78 African Americans, % control: 77%) and those who agree are referred to LU. At LU, both group and one-on-one sessions are conducted, an overall assessment is conducted, and an individualized plan is developed. Classes include education and counseling on diet, physical activity, stress, hypertension disease education, community resources, and patient-physician interaction. Multiple theoretical models will be used such as stages of change, social networking, and precede-proceed models. In addition, Community Health Advisors are used to provide additional support for the participants. Patients kept appropriate diaries for the respective domains. LU will last three months with classes two hours in length being offered every other week and with a monthly field trip to provide demonstration. A pilot group (N=7, mean age=82, 1 male, 1 African American) to test feasibility was conducted. Preliminary opinion of patients and faculty suggested a high degree of acceptability and enjoyment. Specific dietary, physical activity, weight, and hypertension education showed overall improvement. If proven to be effective, this model of care can be applied in various settings and accomplish an improved hypertension control in the elderly population.