Abstract P374: Trends in Hypertension Prevalence, Awareness, Treatment, and Control: The National Health and Nutrition Examination Survey, 1999-2014

Abstract

Introduction: The decline in cardiovascular disease mortality in the US has stalled in recent years, though patterns have varied by age and sociodemographic characteristics. Trends in prevalence of hypertension, as well as awareness, treatment, and control in population subgroups can shed light on opportunities for improving hypertension management and CVD prevention. Hypothesis: There has been greater improvement in hypertension control among adults aged ≥65 years than in middle- and younger-age (45-64 and 25-44 years) adults and that race and socioeconomic disparities may be narrower among adults aged ≥65 years. Methods: We analyzed data for adults aged ≥25 years from the 1999-2014 National Health and Nutrition Examination Survey (NHANES). We examined mean systolic blood pressure (SBP), prevalence of hypertension, and among those with hypertension, prevalence of awareness, treatment, and control by age category and survey cycle. We fit linear regression models for trends with interaction terms for age category and time. Results: Among those aged ≥65, mean SBP decreased 10.4 mmHg, from 143.2 to 132.9 mmHg, a significantly greater decrease than among those aged 45-64 (-3.1 mmHg) or 25-44 (-0.1 mmHg), though absolute SBP values are highest among those aged ≥65 ( Table ). Hypertension awareness, treatment, and control increased significantly each age category, but to a lesser extent among those 45-64 than those ≥65 (p-values for interaction: 0.031, 0.054, 0.051, respectively). Differences in hypertension control and mean SBP among whites and blacks were greater among those 45-64 than those ≥65. Within age categories, there were few significant differences in trends over time by race/ethnicity, education, or poverty to income ratio. Conclusions: Our findings highlight the need to address hypertension management among middle- and younger-age adults. Persistent disparities in hypertension control over time demonstrate that prevention and management of hypertension is a priority health equity issue.