Abstract
INTRODUCTION: The prevalence of hypertension (HT) increases with age. Uncertainty remains about how to treat the oldest patients, who often suffer from multimorbidity. AIM: We explored which factors influence general practitioners' (GPs') and GP trainees' treatment of hypertension among the oldest-old. METHODS: GPs and GP trainees in Sweden were invited to fill out an online survey through announcements in newsletters and closed social media groups. RESULTS: Of the 577 questionnaires that were initiated, 397 were completed (69%). The respondents stated that acceptable blood pressure ranges were 115-152/61-93 mmHg. Regarding factors influencing choices of HT treatment, all respondents considered patient's living conditions more important than medical factors, more so by female (80%) than by male physicians (71%, p = 0.049), and more by respondents less experienced in primary health care (PHC) (83%) compared to more experienced (74%, p = 0.043). Lifestyle recommendations, except dietary advice, were frequently offered (80.4%-91.4%). All respondents identified co-morbidity and cardiovascular risk factors as important for treatment decisions. Respondents with more PHC experience considered HT treatment guidelines more useful than those with less experience (p = 0.012). Improved cooperation with other caregivers and a common medication list were prioritised more by female than male respondents. CONCLUSIONS: Both medical factors and living conditions were important for GPs and GP trainees in making HT treatment decisions for the oldest-old. Female and less experienced respondents prioritised living conditions. Organisational changes in HT care for the oldest-old were more important to female respondents.