Factors Influencing Blood Pressure Control in Older Adults Hypertension: A Systematic Review
Abstract
Hypertension is the leading cause of premature death worldwide, and it increases with age, like many other chronic diseases. Poor blood pressure control behavior is the main cause of hypertension management failure. Objective: Hypertension significantly increases the risk of stroke and heart disease, which is a leading cause of death and disability globally, particularly among older adults. This review identified factors that influence blood pressure control behavior of the elderly with hypertension. Method: The PRISMA guidelines are used as a systematic search in PubMed, Scopus, Sage journals, Google Scholar and Science Direct in 2019 – 2024. The Joanna Briggs Institute's unified analytics framework was adopted for data synthesis. The population in this review is the elderly who suffer from hypertension. Results: A total of 17.542 articles were obtained from the four databases. sixteen articles were selected after extraction and incorporation of inclusion criteria. Conclusion: This review shows that economics, health literacy and education are the main factors in blood pressure control behavior in elderly people suffering from hypertension. Lessons from this review can help improve adherence to hypertension control, prevent health complications, and improve quality of life in the future.
References
Adinkrah, E., Bazargan, M., Wisseh, C., & Assari, S. (2020). Adherence to hypertension medications and lifestyle recommendations among underserved african american middle-aged and older adults. International Journal of Environmental Research and Public Health, 17(18), 1–15. https://doi.org/10.3390/ijerph17186538
Afiani, N., Nurmala, I., & Mahmudah. (2023). A systematic review on the determinants of medication adherence in older adults with hypertension. Journal of Public Health in Africa, 14(S2). https://doi.org/10.4081/jphia.2023.2578
Berutu, S., & Syafitri, R. (2024). Analysis of Factors That Influence Adherence to Taking Medication in Elderly People with Hypertension in the Working Area of Pakpak Bharat District. 2(3), 113–128.
Boro, B., & Banerjee, S. (2022). Decomposing the rural–urban gap in the prevalence of undiagnosed, untreated and under-treated hypertension among older adults in India. BMC Public Health, 22(1), 1–16. https://doi.org/10.1186/s12889-022-13664-1
Burnier, M., Polychronopoulou, E., & Wuerzner, G. (2020). Hypertension and Drug Adherence in the Elderly. Frontiers in Cardiovascular Medicine, 7(April), 1–9. https://doi.org/10.3389/fcvm.2020.00049
Chantakeeree, C., Sormunen, M., Jullamate, P., & Turunen, H. (2021). Health-promoting behaviors among urban and rural older thai adults with hypertension: A cross-sectional study. Pacific Rim International Journal of Nursing Research, 25(2), 242–254. https://www.scopus.com/inward/record.uri?eid=2-s2.0-85104038922&partnerID=40&md5=f486a4b992d3af48bb5390c27e536f78
Choi, H. Y., & Kim, E. (2023). Factors Influencing the Control of Hypertension According to the Gender of Older Adults. Healthcare (Switzerland), 11(11), 1–14. https://doi.org/10.3390/healthcare11111595
Chu, H. Y., Huang, H. C., Huang, C. Y., Chu, C. C., Su, C. T., Tsai, I. L., Hu, H. L. S., & Guo, S. L. (2021). A predictive model for identifying low medication adherence among older adults with hypertension: A classification and regression tree model. Geriatric Nursing, 42(6), 1309–1315. https://doi.org/10.1016/j.gerinurse.2021.08.011
Darvishpour, A., Mansour-Ghanaei, R., & Mansouri, F. (2022). The Relationship Between Health Literacy, Self-Efficacy, and Self-Care Behaviors in Older Adults With Hypertension in the North of Iran. Health Literacy Research and Practice, 6(4), e262–e269. https://doi.org/10.3928/24748307-20221013-01
Delavar, F., Pashaeypoor, S., & Negarandeh, R. (2020). The effects of self-management education tailored to health literacy on medication adherence and blood pressure control among elderly people with primary hypertension: A randomized controlled trial. Patient Education and Counseling, 103(2), 336–342. https://doi.org/10.1016/j.pec.2019.08.028
Demikhov, O., Dehtyarova, I., Rud, O., Khotyeev, Y., Larysa, K., Cherkashyna, L., Demikhova, N., & Orlovskiy, A. (2020). Arterial hypertension prevention as an actual medical and social problem. Bangladesh Journal of Medical Science, 19(4), 722–729. https://doi.org/10.3329/bjms.v19i4.46632
Fan, Y., He, H., Li, H., Chen, Z., Liu, C., Ma, L., Xu, Z., Zhao, J., Wu, Y., Liu, Z., & Shan, G. (2024). The Impact of Marital Status on Hypertension: SEM Analysis of a Chinese General Population Cohort. 1–20. https://doi.org/10.21203/rs.3.rs-4340785/v1
Huy, T. Q., Nguyet, N. T., Nguyet, N. M., & Van Truong, P. (2024). Self-care behavior mediates the relationship between health literacy and blood pressure in older adults with hypertension. Bangladesh Journal of Medical Science, 23(2), 476–483. https://doi.org/10.3329/bjms.v23i2.72176
Jones, L. M., Moss, K. O., Mitchell, J., Still, C., Hawkins, J., Tang, E., & Wright, K. D. (2022). Challenges to dietary hypertension self-management as described by a sample of African American older adults. Worldviews on Evidence-Based Nursing, 19(1), 64–72. https://doi.org/10.1111/wvn.12555
Khasanah, U., Kelliat, B. A., Afiyanti, Y., Besral, B., & Sari, D. W. (2024). The Problems and Needs of Self-Management Among Indonesian Older Adults With Hypertension: A Qualitative Study. SAGE Open Nursing, 10. https://doi.org/10.1177/23779608241282915
Korhonen, M. J., Pentti, J., Hartikainen, J., Ilomäki, J., Setoguchi, S., Liew, D., Kivimäki, M., & Vahtera, J. (2020). Lifestyle Changes in Relation to Initiation of Antihypertensive and Lipid‐Lowering Medication: A Cohort Study. Journal of the American Heart Association, 9(4), e014168. https://doi.org/10.1161/JAHA.119.014168
Maniyara, K., Kodali, P. B., & Thankappan, K. R. (2023). Prevalence, awareness, treatment, control and correlates of prevalence and control of hypertension among older adults in Kerala: A mixed methods study. Indian Heart Journal, 75(3), 185–189. https://doi.org/10.1016/j.ihj.2023.03.004
Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16(4), 223–237. https://doi.org/10.1038/s41581-019-0244-2
Muli, S., Meisinger, C., Heier, M., Thorand, B., Peters, A., & Amann, U. (2020). control of hypertension in older people : results from the population-based KORA-age 1 study. BMC Public Health, 20:1049, 1–10. https://doi.org/10.1186/s12889-020-09165-8
Nagamine, Y., Shobugawa, Y., Sasaki, Y., Takagi, D., Fujiwara, T., Khin, Y. P., Nozaki, I., Shirakura, Y., Kay Thi, L., Poe Ei, Z., Thae, Z., & Win, H. H. (2023). Associations between socioeconomic status and adherence to hypertension treatment among older adults in urban and rural areas in Myanmar: A cross-sectional study using baseline data from the JAGES in Myanmar prospective cohort study. BMJ Open, 13(1), 1–8. https://doi.org/10.1136/bmjopen-2022-065370
Oliveros, E., Patel, H., Kyung, S., Fugar, S., Goldberg, A., Madan, N., & Williams, K. A. (2020). Hypertension in older adults: Assessment, management, and challenges. Clinical Cardiology, 43(2), 99–107. https://doi.org/https://doi.org/10.1002/clc.23303
Ouellet, G. M., McAvay, G., Murphy, T. E., & Tinetti, M. E. (2019). Treatment of Hypertension in Complex Older Adults: How Many Medications Are Needed? Gerontology and Geriatric Medicine, 5, 2333721419856436. https://doi.org/10.1177/2333721419856436
Pobrotyn, P., Chudiak, A., Uchmanowicz, B., Drobnik, J., & Gajda, R. (2023). Adherence problems in elderly patients with hypertension. Medical Research Journal, 1(8), 34–42. https://doi.org/10.5603/mrj.a2023.0004
Świątoniowska-Lonc, N., Polański, J., Mazur, G., & Jankowska-Polańska, B. (2021). Impact of beliefs about medicines on the level of intentional non-adherence to the recommendations of elderly patients with hypertension. International Journal of Environmental Research and Public Health, 18(6), 1–11. https://doi.org/10.3390/ijerph18062825
Wan, J., Wu, Y., Ma, Y., Tao, X., & Wang, A. (2022). Predictors of poor medication adherence of older people with hypertension. Nursing Open, 9(2), 1370–1378. https://doi.org/10.1002/nop2.1183
Yuni, N. K. Y. L. (2023). Correlation between Family Support and Obedience of Blood Pressure Control in Patients with Primary Hypertension. Health and Technology Journal (HTechJ), 1(5), 527–533. https://doi.org/10.53713/htechj.v1i5.114
Zhang, W. li, & Cai, J. (2022). STEP to blood pressure management of elderly hypertension: evidence from Asia. Hypertension Research, 45(4), 576–582. https://doi.org/10.1038/s41440-022-00875-7
Copyright (c) 2025 Indonesian Journal of Global Health Research

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.



