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Blood Pressure Control among US Adults Decreased 11% in Recent Years


New research presented at AHA Hypertension 2020 suggest uncontrolled hypertension is becoming more common among US adults.

Between 2013 and 2018, the percentage of US adults with controlled blood pressure (BP) dropped approximately 11%, according to new research presented at the virtual American Heart Association (AHA) Hypertension 2020 Scientific Sessions.

Previous research found that between 1999-2000, 32.2% of US adults successfully maintained BP <140/90 mm Hg and by 2013-2014 the proportion had increased to 54.5%. However, data from 2015-2016 showed a decrease in percentage to 48%. For this reason, researchers aimed to determine whether that drop continued in 2017-2018 and if any decline was limited to adults aged ≥60 years.

“We cannot assume improvement in blood pressure management will continue, even after 35 years of success. High blood pressure is a serious health risk and deserves constant attention to prevent as many heart attacks and strokes as possible,” said lead author Brent M. Egan, MD, professor, University of South Carolina School of Medicine, Greenville, South Carolina in an AHA press release.

Researchers used National Health and Nutrition Examination Survey (NHANES) data from 2009 to 2018 to assess BP control in adults aged ≥18 years. BP control and its determinants were evaluated in 3 age groups (18-39, 40-59, and ≥60), comparing NHANES data between 2009-2012 and between 2015-2018.

Researchers also examined if participants were previously diagnosed with hypertension and if they were currently taking medication to control hypertension.

It is important to note that in this study hypertension was defined as ≥140/90 mm Hg while the 2017 AHA/American College of Cardiology hypertension guideline states hypertension should be defined as ≥130/80 mm Hg.

Results showed that 11% fewer US adults had controlled hypertension between 2017-2018 vs between 2013-2014 (54.5% vs 43.4%, respectively). Additional key findings include:

  • BP increased 3-4 mm Hg across all age groups.
  • The number of adults ages 40-59 years with successfully managed BP decreased approximately 10% from 2009 to 2018 (56.3% vs 46.6%, respectively).
  • Successful BP control decreased among adults aged ≥60 by 6% from 2009 to 2018 (53.6% vs 47.9%, respectively).

“A closer look at our findings revealed the fall in blood pressure control in older adults was mainly due to less effective use of blood pressure medication and management, so we need to focus on making sure the level of treatment is adequate for this age group. We found the decrease in blood pressure management among the 40-59 age group was mainly due to lack of awareness of and treatment for hypertension,” concluded Egan in the same press release.

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