Abstract MP33: Hypertension Control In The U.s. 2009 To 2018: Rapidly Reversing Years Of Progress.

Abstract

Background: Prior reports show that blood pressure (BP, mmHg) control to <140/<90 in the U.S. rose from 32.2% in 1999-2000 to 54.5% in 2013-14, then fell to 48.0% in 2015-16. In 2014, the BP goal was raised to <150/<90 in adults ≥60 years without diabetes, then lowered to <130/<80 for all adults in 2017. We assessed if the fall in BP control to <140/<90 continued in 2017-2018 and if any decline was limited to adults ≥60 years. Methods: BP control was assessed in adults ≥18 years in NHANES 2009-2018 (age-adjusted to 2010). BP control and its determinants were assessed by age group 18-39, 40-59, and ≥60 years in NHANES 2009-2012 and 2015-2018 (before/after 2014). Terms: Hypertension, BP ≥140 &/or ≥90 or self-reported current BP medication use (Treated); Aware, ‘Yes” to, “Have you been told you have hypertension?”; Treatment efficiency, proportion of treated adults controlled ([Cont]rolled/Treated); BP control, <140/<90. Results: For all adults, BP control peaked in 2013-2014 at 54.5%, declining to 48.0% in 2015-2016 and 43.4% in 2017-2018 (11.1% fall, p<0.001). Comparing 2015-2018 to 2009-2012, BP control, awareness and treatment fell [Table]) in adults 40-59; BP control and treatment efficiency fell in adults ≥60 years (Table); SBP rose 3-4 mm Hg (p≤0.01) in all age groups. Conclusion: Despite the 2017 BP goal <130/<80 in all adults, control to <140/<90 continued to fall in 2017-2018. The fall in BP control impacted adults both ≥60 years, reflecting lower treatment efficiency, and 40-59 years, reflecting less awareness and treatment. Adverse changes in BP and control could increase cardiovascular events and merit prompt attention to drivers of poor control.