High Blood Pressure Control Improving, Prevalence Not Decreasing

About 50% of patients with hypertension have adequate control of their blood pressure, meeting a goal of Healthy People 2010, but the rate of hypertension in the United States has not decreased in recent years, according to a study in The Journal of the American Medical Association.

Brent M. Egan, MD, of the Medical University of South Carolina, Charleston, and colleagues examined changes in hypertension prevalence, awareness, treatment, and control for all adults combined and for subsets by age, race/ethnicity, and sex across National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 1999-2008 in five 2-year blocks, which included 42,856 adults older than 18 years, representing a sample of the U.S. population. Hypertension was defined as systolic blood pressure (BP) of at least 140 mmHg and diastolic BP of at least 90 mmHg, self-reported use of antihypertensive medications, or both.

The researchers found that the rates of hypertension increased from 23.9% in 1988-1994 to 28.5% in 1999-2000, but did not change between 1999-2000 and 2007-2008 (29%). “… prevalent hypertension is not decreasing toward the national goal of 16 percent and will likely remain high unless adverse trends in population nutrition and body mass index occur or phar­macological approaches to hypertension prevention are adopted,” they wrote.

Hypertension control increased from 27.3% in 1988­1994 to 50.1% in 2007-2008, and BP among patients with hypertension decreased from 143.0/80.4 mmHg to 135.2/74.1 mmHg.

“Blood pressure control improved significantly more in absolute percentages between 1999-2000 and 2007-2008 vs. 1988-1994 and 1999-2000. Better BP control reflected improvements in awareness, treatment, and proportion of patients who were treated and had controlled hypertension. Hyper­tension control improved significantly between 1988-1994 and 2007-2008, across age, race, and sex groups, but was lower among individuals aged 18 to 39 years vs. 40 to 59 years and 60 years or older, and in Hispanic vs. white individuals,” the authors wrote.

“Hypertension control improved, despite adverse changes in nutrition and body mass index and reflects increases in awareness, treatment, and patients who were treated attaining target BP, in all individuals with hypertension combined and all age, race, and sex subgroups. However, demographic disparities exist. Broad-based efforts to improve awareness, treatment, and proportion of patients treated and controlled are important for increasing BP control in all groups. Complementary programs to raise awareness and treatment among 18 to 39 years, Hispanic, and male groups and to increase the proportion of patients treated and controlled among 60 years or older, black, and female groups are important for improving hypertension control and reducing disparities,” the researchers concluded.

Source: American Medical Association