Evidence map›Paper›PMID 31427342›Full record

ArticleBMJ open2019

Hypertension management: experiences, wishes and concerns among older people-a qualitative study.

Emma van Bussel, Leony Reurich, Jeannette Pols, Edo Richard, Eric Moll van Charante, Suzanne Ligthart

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
1.4field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Hypertensive patient's journey in Poland.BMC health services research · 2025
    Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Emma van BusselDepartment of Primary Care and Medical Ethics, Amsterdam UMC, AMC, Amsterdam, Netherlands.
Leony ReurichDepartment of Primary Care and Medical Ethics, Amsterdam UMC, AMC, Amsterdam, Netherlands.
Jeannette PolsDepartment of Primary Care and Medical Ethics, Amsterdam UMC, AMC, Amsterdam, Netherlands.
Edo RichardDepartment of Neurology, Amsterdam UMC, AMC, Amsterdam, Netherlands.
Eric Moll van CharanteDepartment of Primary Care and Medical Ethics, Amsterdam UMC, AMC, Amsterdam, Netherlands e.p.mollvancharante@amc.uva.nl.
Suzanne LigthartDepartment of Primary and Community Care, Radbout University Medical Center, Nijmegen, Netherlands.
Amsterdam University Medical Centers · NLRadboud University Nijmegen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesSixty-five per cent of older people have hypertension, but little is known about their preferences and concerns regarding hypertension management. Guidelines on hypertension lack consensus on how to treat older people without previous cardiovascular disease (CVD). This asks for explicit consideration of patient preferences in decision making. Therefore, the aim of this study was to explore older peoples' experiences, preferences, concerns and perceived involvement regarding hypertension management.

designQualitative interview study.

settingParticipants were selected from 11 general practitioner (GP) practices in the Netherlands and purposively sampled until data saturation was achieved. Semistructured interviews were conducted, audio recorded and analysed by two researchers using thematic analysis.

participantsFifteen community dwelling older people aged 74-93 years with hypertension and without previous CVD participated.

resultsInterviewees rarely started the conversation about hypertension management with their GP, although they did have concerns. Reasons for not discussing the subject included low priority of hypertension concerns, reliance on GPs or trust in GPs to make the right decision on their behalf. Also, interviewees anticipated regret of reducing medication, fearing vascular incidents. Interviewees would like to discuss tailoring treatment to their needs, deprescription of medication and ways to reduce side effects. They expected GPs to be more transparent on treatment effects.

conclusionOlder people describe having little involvement in hypertension management, although they have several concerns. Since GPs are also known to be hesitant to bring up this subject, we signal a conspiracy of silence about antihypertensive medication. Through breaking this silence, GPs can facilitate shared decision-making on hypertension management and better tailored care.

Indexed as

Physician-Patient RelationsAgedAged, 80 and overAntihypertensive AgentsFemaleGeneral PractitionersHumansHypertensionMalePatient Education as TopicPatient PreferenceQualitative ResearchAntihypertensive Agentshypertension managementolder peopleprimary careshared decision-making conspiracy of silence

Identifiers

PMID31427342
PMCPMC6701601
OpenAlexW2969662560

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.