Age-adjusted Prevalence Of Hypertension Research Articles

Trends in blood pressure control in US adults with hypertension, 2013-2014 to 2021-2023.

Prior studies have reported a decrease in the proportion of US adults with hypertension that had controlled blood pressure (BP). We analyzed data from the National Health and Nutrition Examination Survey (n=25,128, ≥18 years of age) to determine changes in BP control from 2013-2014 to 2021-2023. Hypertension was defined as systolic BP ≥140 mmHg, diastolic BP ≥90 mmHg or antihypertensive medication use. BP control was defined as systolic BP <140 mmHg and diastolic BP <90 mmHg. The age-adjusted prevalence of hypertension (95%CI) was 32.8% (31.2%-34.4%) in 2013-2014 and 32.0% (30.1%-33.9%) in 2021-2023. Among US adults with hypertension, the age-adjusted proportion (95%CI) with controlled BP was 54.1% (49.1%-59.2%), 48.6% (44.5%-52.7%), and 48.3% (45.8%-50.8%) in 2013-2014, 2015-2016 and 2017-2020, respectively (p-trend=0.058), and 51.1% (47.9%-54.3%) in 2021-2023 (p-value=0.184 comparing 2021-2023 versus 2017-2020). The proportion (95%CI) of US adults taking antihypertensive medication with controlled BP was 72.0% (68.5%-75.5%), 66.7% (62.9%-70.5%), and 67.8% (65.3%-70.3%) in 2013-2014, 2015-2016, and 2017-2020, respectively (p-trend=0.085), and 68.3% (64.8%-71.9%) in 2021-2023 (p-value=0.654 comparing 2021-2023 versus 2017-2020). Among non-Hispanic Black adults, BP control increased from 37.4% (95%CI 33.6%-41.1%) to 49.6% (95%CI 42.3%-56.9%) between 2017-2020 and 2021-2023 for those with hypertension (p-value=0.005), and from 52.6% (95%CI 47.4%-57.8%) to 62.6% (95%CI 55.6%-69.7%) for those taking antihypertensive medication (p-value=0.033). There was no difference in BP control across race/ethnicity groups in 2021-2023. The decline in BP control from 2013-2014 to 2017-2020 did not continue through 2021-2023. An increase in BP control occurred from 2017-2020 and 2021-2023 among non-Hispanic Black adults.

Trends in prevalence of hypertension and high-normal blood pressure among US adults, 1999–2018

Hypertension and high-normal blood pressure (BP) increase the risk for cardiovascular diseases. Examining trends in hypertension and high-normal BP among US adults is crucial. Participants aged 20 years or older from the 1999–2018 National Health and Nutrition Examination Surveys, were included. Trend analyses were performed to assess temporal changes in prevalence of hypertension and high-normal BP among US adults. Among the 48,580 participants included in this analysis, the mean (SD) age was 47.2 years (18 years) and 50.9% were women. Age-adjusted prevalence of hypertension was stable from 1999 to 2000 (29.5% [95% CI 26.6–32.3%]) through 2017–2018 (31.9%, [95% CI 29.0–34.7%]) (P = 0.265 for linear trend). Age-adjusted prevalence of high-normal BP decreased from 10.9% (95% CI 9.4–12.5%) in 1999–2000 to 8.0% (95% CI 7.1–9.0%) in 2007–2008, then increased to 9.8% (95% CI 8.3–11.3%) in 2017–2018 (P = 0.002 for nonlinear trend). Compared with men, hypertension and high-normal BP was less likely among women (multivariable-adjusted prevalence ratio, 0.90 [95% CI 0.84–0.97]; 0.68 [95% CI 0.52–0.88], respectively). Compared with non-Hispanic Black, high-normal BP was less likely among Mexican American, non-Hispanic White, and other race (multivariable-adjusted prevalence ratio, 0.59 [95% CI 0.44–0.79]; 0.53 [95% CI 0.41–0.69]; 0.56 [95% CI 0.74 − 0.71], respectively). The same held for hypertension.

Hypertension and its determinants in Abu Dhabi population: a retrospective cohort study.

Preventing high blood pressure and its complications requires identifying its risk factors. This study assessed predictors of hypertension and its associated complications among Emirati adults in Abu Dhabi, United Arab Emirates (UAE). This retrospective cohort study was conducted by retrieving data from the Electronic Medical Records (EMR) of Emiratis who participated in a national cardiovascular screening program between 2011 and 2013. The study cohort comprised 8456 Emirati adults (18 years and above): 4095 women and 4361 men. The average follow-up period was 9.2 years, with a maximum of 12 years. The age-adjusted hypertension prevalence in Abu Dhabi increased from 24.5% at baseline to 35.2% in 2023. At baseline, 61.8% of hypertensive patients had controlled blood pressure, which increased to 74.3% in 2023. Among those free from hypertension at screening, 835 patients (12.3%) were newly diagnosed during the follow-up period. Using Cox regression, the hypertension prediction model developed included age [P value <0.001, hazard ratio 1.051, 95% confidence interval (CI) 1.046-1.056], SBP (P value <0.001, hazard ratio 1.017, 95% CI 1.011-1.023) and DBP (P value <0.001, hazard ratio 1.029, 95% CI 1.02-1.037), glycated hemoglobin (P < 0.001, hazard ratio 1.132, 95% CI 1.077-1.191), and high-density lipoprotein cholesterol (HDL-C) (P value <0.001, hazard ratio 0.662, 95% CI 0.526-0.832). This prediction model had a c-statistic of 0.803 (95% CI 0.786-0.819). Using survival analysis (Kaplan-Meier), higher blood pressure was associated with more cardiovascular events and mortality during follow-up. Targeting population-specific predictors of hypertension can prevent its progression and inform healthcare professionals and policymakers to decrease the incidence, complications, and mortality related to hypertension.

Is gender a factor in socioeconomic disparities in undiagnosed, and untreated hypertension in Bangladesh?

Our objectives were to ascertain the following: (1) the prevalence and socioeconomic distribution of hypertension (HTN), undiagnosed for HTN, and untreated cases of HTN-diagnosed individuals; (2) the relationship between SES and the prevalence of HTN, undiagnosed for HTN, and untreated for HTN; and (3) whether sex moderate this association. Data from the 2017-18 Bangladesh Demographic Health Survey were used. 11,776 participants who were 18 years of age or older responded toour analysis. The age-adjusted prevalence of HTN, undiagnosed for HTN, and untreated cases was 25.1%, 57.2%, and 12.3%. Compared to females, males were less likely to have HTN but more likely to have undiagnosed HTN. People in the rich SES groups had a higher odd of (adjusted odds ratio [aoR] 1.25; 95% confidence interval [CI] 1.08-3.45) of having HTN compared to those in the poor SES group. When compared to individuals in the poor SES group, those in the rich SES group had lower odds of undiagnosed (aoR 0.57; 95% CI 0.44-0.74) and untreated (aoR 0.56; 95% CI 0.31-0.98) for HTN. Sex moderated the association between SES and HTN prevalence, which showed that men from rich SES were more likely to suffer from HTN than men from poor SES. According to this study, the government and other pertinent stakeholders should concentrate more on developing suitable policy measures to reduce the risk of HTN, particularly for men in rich socioeconomic groups. They should also concentrate on screening and diagnosing HTN in socioeconomically disadvantaged populations, regardless of sex.

Hypertension Prevalence and Related Risk Factors Among Mexican American Adults Are Increasing: National Health and Nutrition Examination Survey 1999 to 2018.

Acculturation affects hypertension prevalence among Hispanic people, but there have been no recent analyses specifically focused on Mexican American (MA) people. We sought to determine age-adjusted hypertension prevalence, abdominal obesity, and acculturation trends among MA adults and non-Hispanic White adults. Data from the NHANES (National Health and Nutrition Examination Survey) were analyzed in 2-year increments to observe trends in hypertension and risk factors (age, sex, body mass index, smoking status, abdominal obesity, waist-to-height ratio (WHtR), education, and income). Acculturation was based on three commonly used measures. The sample included 30 920 adults. Age-adjusted hypertension prevalence is higher in MA adults (52.7%) than White adults (48.3%). Hypertension risk factors-age, obesity prevalence, WHtR, acculturation-all significantly increased among MA adults, while smoking declined. Higher acculturation scores increased hypertension likelihood (odds ratio [OR], 1.44 [95% CI, 0.91-1.97]) for MA adults compared with those with lower acculturation scores. White adults with elevated WHtR >0.5 had a 40% higher risk of hypertension than those with WHtR <0.5, but among MA adults, elevated WHtR did not increase risk for hypertension. There was a significant increase in hypertension prevalence among MA adults from 2003 to 2018 at an average biennial rate of 2.23%. There was no change in hypertension prevalence among White adults from 1999 to 2018. Over 20 years of NHANES, more highly acculturated MA adults were at greater risk for hypertension, despite declines in smoking and controlling for age, sex, obesity status, education, and income. Finding ways to promote more traditional lifestyle and eating habits for MA adults could be a beneficial approach to reducing hypertension risk factors in this population.

Increasing trend in hypertension prevalence among Korean adolescents from 2007 to 2020

BackgroundThe purpose of this study was to examine the prevalence of hypertension in Korean adolescents, its long-term trends, and factors associated with the development of hypertension.MethodsData of the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2020 were combined into three time periods (2007–2011, 2012–2016, and 2017–2020). A total of 11,146 Korean adolescents aged 10–18 were included in the analysis. The definition of hypertension was based on the 2017 American Academy of Pediatrics guidelines for hypertension.ResultsThe age-adjusted prevalence of hypertension was 5.47%, 7.85%, and 9.92% in 2007–2011, 2012–2016, and 2017–2020, respectively. Long-term trend analysis using Joinpoint analysis over the observation period showed a significantly increasing trend in hypertension prevalence with a mean annual percentage change of 6.4%. Boys, those aged 13–15, those aged 16–18, overweight/obese, and those living in urban areas were more likely to develop hypertension (OR 1.980, 1.492, 3.180, 2.943, and 1.330, respectively).ConclusionThe prevalence of hypertension in Korean adolescents was higher than the global prevalence of hypertension and showed an increase over a 13–year period. Targeted strategies for prevention and early detection of hypertension are needed in this population.

Population-based cross-sectional study of sex-specific dose-response associations between night sleep duration and hypertension in Islamic Republic of Iran.

Several studies have suggested that sleep disorders have adverse effects on blood pressure. However, the findings remain controversial and only a few studies have investigated the association between sleep duration and hypertension among all age and sex subgroups. To evaluate the dose-response association between sleep duration and blood pressure in the Iranian population using the Ravansar non-communicable disease cohort study. This was a cross-sectional study of 9865 participants aged 35-65 years from the 2014-2017 Ravansar non-communicable disease cohort study. Night sleep duration was classified as ≤5 hours, 6 hours, 7 hours, 8 hours, 9 hours, and ≥10 hours. The association between self-reported sleep duration and hypertension was examined using multivariable logistic regression in STATA version 14. Restricted cubic spline analysis showed the dose-response association between sleep duration and hypertension. The age-adjusted prevalence of hypertension was 16.50% among men, 24.20% among women and 20.50% in the total population. Compared with reference sleep duration (7 hours) in the total population, the multivariable odds ratio [OR (95% CI)] for hypertension was 0.70 (0.55-0.88) for the group with 9 hours sleep duration and 0.90 (0.74-1.09) for the group with ≤5 hours sleep duration. Among pre-menopausal women, we observed an inverse association between 9 hours sleep duration and hypertension [0.62 (0.42-0.90)]. The age-adjusted cubic spline suggested a linear inverse association between sleep duration and prevalence of hypertension among men and the total population and a non-linear association among women. Longer sleep duration (from 9 hours) had a negative association with hypertension. Further studies are needed to identify the risk factors associated with sleep duration and hypertension among the general population in the Islamic Republic of Iran.

Hypertension Statistics for US Adults: An Open-Source Web Application for Analysis and Visualization of National Health and Nutrition Examination Survey Data.

Data from the US National Health and Nutrition Examination Survey are freely available and can be analyzed to produce hypertension statistics for the noninstitutionalized US population. The analysis of these data requires statistical programming expertise and knowledge of National Health and Nutrition Examination Survey methodology. We developed a web-based application that provides hypertension statistics for US adults using 10 cycles of National Health and Nutrition Examination Survey data, 1999 to 2000 through 2017 to 2020. We validated the application by reproducing results from prior publications. The application's interface allows users to estimate crude and age-adjusted means, quantiles, and proportions. Population counts can also be estimated. To demonstrate the application's capabilities, we estimated hypertension statistics for noninstitutionalized US adults. The estimated mean systolic blood pressure (BP) declined from 123 mm Hg in 1999 to 2000 to 120 mm Hg in 2009 to 2010 and increased to 123 mm Hg in 2017 to 2020. The age-adjusted prevalence of hypertension (ie, systolic BP≥130 mm Hg, diastolic BP≥80 mm Hg or self-reported antihypertensive medication use) was 47.9% in 1999 to 2000, 43.0% in 2009 to 2010, and 44.7% in 2017 to 2020. In 2017 to 2020, an estimated 115.3 million US adults had hypertension. The age-adjusted prevalence of controlled BP, defined by the 2017 American College of Cardiology/American Heart Association BP guideline, among nonpregnant US adults with hypertension was 9.7% in 1999 to 2000, 25.0% in 2013 to 2014, and 21.9% in 2017 to 2020. After age adjustment and among nonpregnant US adults who self-reported taking antihypertensive medication, 27.5%, 48.5%, and 43.0% had controlled BP in 1999 to 2000, 2013 to 2014, and 2017 to 2020, respectively. The application developed in the current study is publicly available at https://bcjaeger.shinyapps.io/nhanesShinyBP/ and produced valid, transparent and reproducible results.

Abstract P106: Prevalence of Cardiometabolic Risk Factors in Patients With versus Without Cancer: Insights From a Large US Healthcare System

Background: Although cardiometabolic dysfunction is associated with an increased risk of cancer, the prevalence of cardiometabolic risk factors in patients with and without cancer remains less well-established. Therefore, we aimed to examine the prevalence and association of cardiometabolic risk factors in patients with versus without cancer who do not have established atherosclerotic cardiovascular disease (ASCVD). Methods: Data of ∼1.1 million patients aged 18+ years in the Houston Methodist Learning Health System Outpatient Registry was utilized to identify patients with and without cancer with cardiometabolic risk factors including hyperlipidemia, diabetes mellitus (DM), obesity and hypertension using the ICD-10 codes. Patients with prevalent ASCVD were excluded. Age-adjusted prevalence of cardiometabolic risk factors was calculated and multivariate logistic regression models were utilized to determine the association between cardiometabolic factors and risk of cancer. Results: A total of 76,312 (7.8%) patients with cancer and 897,408 (92.2%) patients without cancer were included. Compared with patients without cancer, patients with cancer had increased age-adjusted prevalence of hypertension (38.4% vs 33.4%), obesity (30.7% vs 29.6%), hyperlipidemia (26.0% vs 22.0%) and DM (13.9% vs 11.0%). Compared with patients without cancer, patients with cancer had significantly increased odds of hyperlipidemia (OR 1.32 [1.30, 1.34]), hypertension (OR 1.82 [1.79, 1.85]) and DM (OR 1.42 [1.39, 1.45]). Conversely, obese patients were less likely to have cancer (OR 0.96 [0.95, 0.98]) compared with patients without cancer. Conclusion: Amongst patients without established ASCVD, increased prevalence of cardiometabolic risk factors is observed in patients with cancer versus without cancer. Strategies optimizing cardiometabolic health such as routine screening, monitoring, evaluation, and management of these factors should be prioritized to curtail adverse cardiovascular and cancer outcomes.

Urbanization and cardiovascular health among Indigenous groups in Brazil

BackgroundWe described the prevalence of cardiovascular risk factors in groups of Brazilian Indigenous people at different degrees of urbanization.MethodsThe Project of Atherosclerosis among Indigenous populations (Projeto de Aterosclerose em Indígenas; PAI) is a cross-sectional study conducted in Northeast Brazil between August 2016–June 2017. It included three populations: Fulni-ô Indigenous people (lowest degree of urbanization), Truká Indigenous people (greater urbanization), and a highly urbanized non-Indigenous local cohort (control group). Participants were assessed to register sociodemographic, anthropometric, as well as clinical and laboratory-derived cardiovascular (CV) risk parameters. Age-adjusted prevalence of hypertension was also computed. Nonparametric tests were used for group comparisons.ResultsHere we included 999 participants, with a predominance of females in all three groups (68.3% Control group, 65.0% Fulni-ô indigenous group, and 60.1% Truká indigenous group). Obesity was present in 45.6% of the urban non-Indigenous population, 37.7% Truká and in 27.6% Fulni-ô participants. The prevalence of hypertension was 29.1% (n = 297) with lower prevalence in the less urbanized Fulni-ô people (Fulni-ô – 18.2%; Truká – 33.9%; and Control – 33.8%; p < 0.001). In the elderly male population, the prevalence of hypertension was 18.7% in the Fulni-ô, 45.8% in the Truká, and 54.5% in the control group. Of the 342 participants that self-reported hypertension, 37.5% (n = 68) showed uncontrolled blood pressure (BP). Uncontrolled BP was more prevalent among Truká people when compared to Fulni-ô people and non-Indigenous participants (45.4%, 22.9%, and 40.7%, respectively; p < 0.001).ConclusionsWe found a higher cardiovascular risk in communities with a higher degree of urbanization, suggesting that living in towns and cities may have a negative impact on these aspects of cardiovascular health.

PS-BPC12-4: HYPERTENSION IN CAMEROONIAN RURAL AND URBAN PYGMIES AND BANTUS OF THE SOUTHERN REGION

Objective: To determine the prevalence of hypertension and associated risk factors among rural and urban pygmy and Bantu dwellers of southern Cameroon Design and Methods: In this cross-sectional cluster sampling survey, we examined 100 traditional pygmies (TP) living in equatorial forest in Kavabousse village under hunter-gatherer subsistence mode, 100 traditional Bantus (TB) living in Bidjouka village closed to Kavabousse (rural area); and 100 contemporary pygmies (CP) and 100 contemporary Bantus (CB) both living in the same urban environment in Kribi city. Trained observers recorded in each participant lifestyle and socio-demographic data, and clinical parameters. Brachial systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured in triplicate using an automatic sphygmomanometer (Omron 705 CP). Hypertension was defined as SBP/DBP &gt; or = 140/90 mmHg. Results: As compared to Bantus, Pygmies were younger (38 ± 16 vs 45 ± 17 years, p = 0.0001), with lower body mass index (22.7 ± 3.3 vs 24.9 ± 4.6, p &lt; 0.0001). Age-adjusted SBP and DBP were lower in Pygmies than in Bantus (p &lt; 0.0001), however within group SBP and DBP were similar among rural and urban individuals. Age-adjusted prevalence of hypertension was lower in pygmies than Bantus globally (7.5% vs 21.5% p = 0.0001), and in rural and urban areas: 4% vs 19% and 11% vs 24 %, respectively, both p &lt; 0.01). In pygmies taken separately, the age-adjusted prevalence of hypertension was lower in TP than in CP (4% vs 11%). In the whole study population, multivariate logistic regression analysis revealed that hypertension was independently associated with urban area (OR = 2.15, 95%CI: 1.14–4.05), Bantu status (OR = 2.17, 95%CI: 1.09–4.34), age &gt; or = 50 years (OR = 2.15, 95%CI: 1.14–4.05), and abdominal obesity (OR = 0.20 95%CI: 0.09–0.46) (all p &lt; 0.05). In pygmies taken separately, multivariate logistic regression analysis shown that age &gt; or = 50 years (OR = 3.83, CI95%: 1.33–11.36) and urban area (OR = 3.33, CI95%: 1.04–11.11) (both p &lt; 0.05) were independent determinants of hypertension. Conclusion: This study reveals that hunter-gatherer lifestyle is associated with lower prevalence of hypertension as illustrated in TP. Hypertension is more common in Bantus and CP, and is largely attributable to their westernized lifestyle and the growing urbanization of rural area.

Urban–rural disparities in hypertension prevalence, awareness, treatment, and control among Chinese middle-aged and older adults from 2011 to 2015: a repeated cross-sectional study

BackgroundChina has experienced a continuing increase in hypertension prevalence over the past few decades, especially in rural areas. The paper aims to examine the variation of urban–rural disparities in hypertension prevalence, awareness, treatment, and control among Chinese middle-aged and older adults between 2011 and 2015.MethodsOur team extracted data from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey of residents aged 45 years and older. In this study, we used the 2011 wave and the 2015 wave of CHARLS. We calculated crude rates and age-adjusted rates of hypertension prevalence, awareness, treatment, and control for the general, urban, and rural populations in each wave and performed chi-square tests to examine urban–rural disparities. We used logistic regression to further confirm these disparities by controlling confounding factors in each wave. We then used generalized estimating equation (GEE) to further examine whether urban–rural disparities changed between 2011 and 2015.ResultsWe included 11,129 records in the 2011 wave and 8916 records in the 2015 wave in this study. The mean age was 59.0 years and 5359 (48.2%) participants were male in the 2011 wave. Age-adjusted hypertension prevalence, awareness, treatment, control, and control among treated in the total population were 38.5%, 70.6%, 59.2%, 27.4%, and 46.4% in 2015. Urban–rural disparities in the indicators mentioned above were 5.7%, 13.4%, 15.3%, 9.4% and 5.6% in 2011; which decreased to 4.8%, 2.7%, 5.2%, 4.9% and 3.8% in 2015. Urban–rural disparities in prevalence, awareness and treatment were statistically significant in 2011 but not significant in 2015 adjusted for confounding factors, yet control disparities were statistically significant in both waves. Finally, urban–rural disparities in awareness and treatment had narrowed from 2011 to 2015.ConclusionsAwareness, treatment, and control rates were sub-optimal among both urban and rural adults. Prevention and management of hypertension among both urban and rural adults should be further strengthened. Awareness and treatment increased more rapidly among rural adults, indicating some achievement had been made in enhancing the healthcare system in rural areas. More efforts are needed in attaining urban–rural equity of healthcare services.

HYPERTENSION IN CAMEROONIAN RURAL AND URBAN PYGMIES AND BANTUS OF THE SOUTHERN REGION

Objective: To determine the prevalence of hypertension and associated risk factors among rural and urban pygmy and Bantu dwellers of southern Cameroon Design and method: In this cross-sectional cluster sampling survey, we examined 100 traditional pygmies (TP) living in equatorial forest in Kavabousse village under hunter-gatherer subsistence mode, 100 traditional Bantus (TB) living in Bidjouka village closed to Kavabousse (rural area); and 100 contemporary pygmies (CP) and 100 contemporary Bantus (CB) both living in the same urban environment in Kribi city. Trained observers recorded in each participant lifestyle and socio-demographic data, and clinical parameters. Brachial systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured in triplicate using an automatic sphygmomanometer (Omron 705 CP). Hypertension was defined as SBP/DBP &gt; or = 140/90 mmHg. Results: As compared to Bantus, Pygmies were younger (38 ± 16 vs 45 ± 17 years, p = 0.0001), with lower body mass index (22.7 ± 3.3 vs 24.9 ± 4.6, p &lt; 0.0001). Age-adjusted SBP and DBP were lower in Pygmies than in Bantus (p &lt; 0.0001), however within group SBP and DBP were similar among rural and urban individuals. Age-adjusted prevalence of hypertension was lower in pygmies than Bantus globally (7.5% vs 21.5% p = 0.0001), and in rural and urban areas: 4% vs 19% and 11% vs 24 %, respectively, both p &lt; 0.01). In pygmies taken separately, the age-adjusted prevalence of hypertension was lower in TP than in CP (4% vs 11%). In the whole study population, multivariate logistic regression analysis revealed that hypertension was independently associated with urban area (OR = 2.15, 95%CI: 1.14–4.05), Bantu status (OR = 2.17, 95%CI: 1.09–4.34), age &gt;or = 50 years (OR = 2.15, 95%CI: 1.14–4.05), and abdominal obesity (OR = 0.20 95%CI: 0.09–0.46) (all p &lt; 0.05). In pygmies taken separately, multivariate logistic regression analysis shown that age &gt;or = 50 years (OR = 3.83, CI95%: 1.33–11.36) and urban area (OR = 3.33, CI95%: 1.04–11.11) (both p &lt; 0.05) were independent determinants of hypertension. Conclusions: This study reveals that hunter-gatherer lifestyle is associated with lower prevalence of hypertension as illustrated in TP. Hypertension is more common in Bantus and CP, and is largely attributable to their westernized lifestyle and the growing urbanization of rural area.

Blood Pressure Control Among US Adults, 2009 to 2012 Through 2017 to 2020.

Background:The National Health and Nutrition Examination Survey data indicate that the proportion of US adults with hypertension that had controlled blood pressure (BP) declined from 2013 to 2014 through 2017 to 2018. We analyzed data from National Health and Nutrition Examination Survey 2009 to 2012, 2013 to 2016, and 2017 to 2020 to confirm this finding.Methods:Hypertension was defined as systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg or antihypertensive medication use. BP control among those with hypertension was defined as systolic BP <140 mm Hg and diastolic BP <90 mm Hg.Results:The age-adjusted prevalence of hypertension was 31.5% (95% CI, 30.3%–32.8%), 32.0% (95% CI, 30.6%–33.3%), and 32.9% (95% CI, 31.0%–34.7%) in 2009 to 2012, 2013 to 2016, and 2017 to 2020, respectively (P trend=0.218). The age-adjusted prevalence of hypertension increased among non-Hispanic Asian adults from 27.0% in 2011 to 2012 to 33.5% in 2017 to 2020 (P trend=0.003). Among Hispanic adults, the age-adjusted prevalence of hypertension increased from 29.4% in 2009 to 2012 to 33.2% in 2017 to 2020 (P trend=0.029). In 2009 to 2012, 2013 to 2016, and 2017 to 2020, 52.8% (95% CI, 50.0%–55.7%), 51.3% (95% CI, 47.9%–54.6%), and 48.2% (95% CI, 45.7%–50.8%) of US adults with hypertension had controlled BP (P trend=0.034). Among US adults taking antihypertensive medication, 69.9% (95% CI, 67.8%–72.0%), 69.3% (95% CI, 66.6%–71.9%), and 67.7% (95% CI, 65.2%–70.3%) had controlled BP in 2009 to 2012, 2013 to 2016, and 2017 to 2020, respectively (P trend=0.189). Among all US adults with hypertension and those taking antihypertensive medication, a decline in BP control between 2009 to 2012 and 2017 to 2020 occurred among those ≥75 years, women, and non-Hispanic black adults.Conclusions:These data confirm that the proportion of US adults with hypertension who have controlled BP has declined.

Differences in Hypertension and Stage II Hypertension by Demographic and Risk Factors, Obtained by Two Different Protocols in US Adults: National Health and Nutrition Examination Survey, 2017-2018.

To compare prevalence of hypertension and stage II hypertension assessed by 2 blood pressure (BP) observation protocols. Participants aged 18 years and older (n = 4,689) in the National Health and Nutrition Examination Survey (NHANES 2017-2018) had their BP measured following 2 protocols: the legacy auscultation protocol (AP) and oscillometric protocol (OP). The order of protocols was randomly assigned. Prevalence estimates for hypertension (BP ≥130/80 mm Hg or use of medication for hypertension) and stage II hypertension (BP ≥140/90 mm Hg) were determined overall, by demographics, and by risk factors for each protocol. Ratios (OP% ÷ AP%) and kappa statistics were calculated. Age-adjusted hypertension prevalence was 44.5% (95% confidence interval [CI]: 41.1%-48.0%) using OP and 45.1% (95% CI: 41.5%-48.7%) using AP, prevalence ratio = 0.99 (95% CI = 0.94-1.04). Age-adjusted stage II hypertension prevalence was 15.8% (95% CI: 13.6%-18.2%) using AP and 17.1% (95% CI: 14.7%-19.7%) using OP, prevalence ratio = 0.92 (95% CI = 0.81-1.04). For both hypertension and stage II hypertension, the prevalence ratios by demographics and by risk factors all included unity in their 95% CI, except for stage II hypertension in adults 60+ years (ratio: 0.88 [95% CI: 0.78-0.98]). Kappa for agreement between protocols for hypertension and stage II hypertension was 0.75 (95% CI = 0.71-0.79) and 0.67 (95% CI = 0.61-0.72), respectively. In adults and for nearly all subcategories there were no significant differences in prevalence of hypertension and stage II hypertension between protocols, indicating that protocol change may not affect the national prevalence estimates of hypertension and stage II hypertension.

Cardiovascular risk profile of Middle Eastern immigrants living in the United States-the National Health Interview Survey

BackgroundMiddle Eastern (ME) immigrants are one of the fastest-growing groups in the US. Although ME countries have a high burden of atherosclerotic cardiovascular disease (ASCVD), the cardiovascular health status among ME immigrants in the US has not been studied in detail. This study aims to characterize the cardiovascular health status (CVD risk factors and ASCVD burden) among ME immigrants in the US. MethodsWe used 2012–2018 data from the National Health Interview Survey, a US nationally representative survey. ME origin, CVD risk factors, and ASCVD status were self-reported. We compared these to US-born non-Hispanic white (NHW) individuals in the US. ResultsAmong 139,778 adults included, 886 (representing 1.3 million individuals, mean age 46.8) were of ME origin, and 138,892 were US-born NHWs (representing 150 million US adults, mean age 49.3). ME participants were more likely to have higher education, lower income and be uninsured. The age-adjusted prevalence of hypertension (22.4% vs 27.4%) and obesity (21.4% vs 31.4%) were significantly lower in ME vs NHW participants, respectively. There were no significant differences between the groups in the age-adjusted prevalence of ASCVD, diabetes, hyperlipidemia, and smoking. Only insufficient physical activity was higher among ME individuals. ME immigrants living in the US for 10 years or more reported higher age-adjusted prevalence of hypertension, hyperlipidemia, and ASCVD. ConclusionsME immigrants in the US have lower odds of hypertension and obesity, and of having a suboptimal CRF profile compared to US-born NHWs. Further studies are needed to determine whether these findings are related to lower risk, selection of a healthier ME subgroup in NHIS, or possible under-detection of cardiovascular risk factors in ME immigrants living in the US.

Abstract 13366: Cardiovascular Risk Profile of Middle Eastern Immigrants Living in the United States

Introduction: Middle Eastern (ME) immigrants are one of the fastest-growing groups in the US. Several studies have noted a relatively high burden of CVD in ME countries. In the US, while their risk profile has been partially described as part of immigrant studies, the burden of risk factors and ASCVD have not been studied in detail among ME immigrants. Methods: We used 2012-2018 data from the National Health Interview Survey (NHIS), a US nationally representative survey. ME origin was ascertained through self-reported region of birth. ASCVD and CVD risk factors were also self-reported. We compared these to US-born non-Hispanic white (NHW) individuals in the US, using chi-square tests and logistic regression models. Results: Among 139,778 adults included, 886 (representing 1.3 million individuals, mean age 46.8) were of ME origin, and 138,892 were US-born NHWs (representing 150 million US adults, mean age 49.3). ME participants were more likely to have higher education, lower income and be uninsured. The age-adjusted prevalence of hypertension (22.7% vs 27.8%) and obesity (22.1% vs 32%) were significantly lower in MEs vs NHWs participants, respectively. There were no significant differences between the groups in the age-adjusted prevalence of ASCVD, diabetes, hyperlipidemia, and smoking. Only physical inactivity was higher among ME individuals (Fig) . In multivariable analyses, ME participants had lower odds of hypertension (OR 0.71, 95% CI 0.61, 0.83) and obesity (OR 0.61, 95% CI 0.52, 0.72), and higher odds of physical inactivity (OR 1.30, 95% CI 1.11, 1.53), with no significant differences in the other factors or ASCVD (Fig) . Conclusions: ME immigrants in the US exhibit a more favourable cardiovascular risk profile compared to NHWs. Further studies are needed to determine whether this finding is related to lower risk, selection of a healthier ME subgroup in NHIS, or possible under-detection of cardiovascular risk factors in ME immigrants living in the US.

Prevalence and associated factors of hypertension among veterans of the Indian Gorkha regiments living in Pokhara Metropolitan City, Nepal

BackgroundHypertension is a major preventable risk factor for cardiovascular disease. Occupational factors such as having served or serving in armed forces may be associated with hypertension. This study aimed to assess the prevalence and factors associated with hypertension among veterans of the Indian Gorkha army living in western Nepal.MethodsA community-based cross-sectional study was conducted among the veterans living in the Pokhara metropolitan city. Data on blood pressure (BP), anthropometric measurements, and behavioral factors were collected by face-to-face interviews using the World Health Organization's non-communicable disease risk factor surveillance (STEPS) tool. Hypertension was defined as systolic blood pressure (BP) ≥ 140 mm Hg and/or diastolic BP of ≥ 90 mm Hg or currently on antihypertensive medication.ResultsThe age-adjusted prevalence of hypertension was 66.2 % among the study participants (317). Mean systolic and diastolic blood pressure was 144.5 mmHg (± 18.3) and 89.3mmHg (± 16.0), respectively. Among the hypertensive participants, 67 % were aware of their disease, 90 % of them were under treatment, and 14 % of the individuals who received treatment had their hypertension under control. The proportion of smokers was 12.9 % and alcohol drinker was 86.1 %. One-fourth (25.9 %) of the participants had a family history of hypertension. Veterans aged 55-64 years had higher odds (AOR: 5.3; 95 % CI: 1.8–15.9; p = 0.003) of being associated with hypertension as compared to 35–44 years. Being a current alcohol drinker (AOR: 2.5; 95 % CI: 1.4–4.5; p = 0.003), overweight (AOR: 1.9; 95 % CI: 1.0-3.5; p = 0.04), obese (AOR: 3.1; 95 % CI: 1.1–8.3; p = 0.03) and family history of hypertension (AOR: 2.9; 95 % CI: 1.5–5.8; p = 0.002) were independently associated with hypertension.ConclusionsHypertension was prevalent in retired Nepal veterans. Hypertension was associated with a number of modifiable lifestyle and behavioral factors. Our findings suggest the need for screening, education and management of Nepal veterans for hypertension.

Hypertension prevalence in the All of Us Research Program among groups traditionally underrepresented in medical research

The All of Us Research Program was designed to enable broad-based precision medicine research in a cohort of unprecedented scale and diversity. Hypertension (HTN) is a major public health concern. The validity of HTN data and definition of hypertension cases in the All of Us (AoU) Research Program for use in rule-based algorithms is unknown. In this cross-sectional, population-based study, we compare HTN prevalence in the AoU Research Program to HTN prevalence in the 2015–2016 National Health and Nutrition Examination Survey (NHANES). We used AoU baseline data from patient (age ≥ 18) measurements (PM), surveys, and electronic health record (EHR) blood pressure measurements. We retrospectively examined the prevalence of HTN in the EHR cohort using Systemized Nomenclature of Medicine (SNOMED) codes and blood pressure medications recorded in the EHR. We defined HTN as the participant having at least 2 HTN diagnosis/billing codes on separate dates in the EHR data AND at least one HTN medication. We calculated an age-standardized HTN prevalence according to the age distribution of the U.S. Census, using 3 groups (18–39, 40–59, and ≥ 60). Among the 185,770 participants enrolled in the AoU Cohort (mean age at enrollment = 51.2 years) available in a Researcher Workbench as of October 2019, EHR data was available for at least one SNOMED code from 112,805 participants, medications for 104,230 participants, and 103,490 participants had both medication and SNOMED data. The total number of persons with SNOMED codes on at least two distinct dates and at least one antihypertensive medication was 33,310 for a crude prevalence of HTN of 32.2%. AoU age-adjusted HTN prevalence was 27.9% using 3 groups compared to 29.6% in NHANES. The AoU cohort is a growing source of diverse longitudinal data to study hypertension nationwide and develop precision rule-based algorithms for use in hypertension treatment and prevention research. The prevalence of hypertension in this cohort is similar to that in prior population-based surveys.

National Health and Nutrition Examination Survey 2017-March 2020 Prepandemic Data Files-Development of Files and Prevalence Estimates for Selected Health Outcomes.

In March 2020, the coronavirus disease 2019 (COVID-19) pandemic halted National Health and Nutrition Examination Survey (NHANES) field operations. As data collected in the partial 2019-2020 cycle (herein referred to as 2019-March 2020) are not nationally representative, they were combined with previously released 2017-2018 data to produce nationally representative estimates. This report explains the creation of the 2017-March 2020 prepandemic data files, provides recommendations for and limitations of the files' use, and presents prevalence estimates for selected health outcomes based on the files. The 2019-2020 primary sampling units (PSUs) were reassigned to the 2015-2018 sample design strata and combined with the 2017-2018 data to create a data set that could be used to calculate nationally representative estimates. A PSU-level adjustment factor was created to equalize the contribution of each stratum to the total survey sample and applied to participant base weights. Interview and examination weights were calculated from the adjusted base weights. The performance of final interview weights was assessed by comparing the demographic characteristics of the weighted NHANES 2017-March 2020 prepandemic sample with nationally representative estimates from the 2018 5-year American Community Survey. Prevalence estimates and 95% confidence intervals were calculated for selected health outcomes. Among children and adolescents aged 2-19 years, the prevalence of obesity was 19.7% and the prevalence of untreated or restored dental caries in one or more primary or permanent teeth was 46.0%. Among adults aged 20 and over, the age-adjusted prevalence of obesity was 41.9%, severe obesity was 9.2%, and diabetes was 14.8%. Among adults aged 18 and over, the age-adjusted prevalence of hypertension was 45.1%. Among adults aged 65 and over, the age-adjusted prevalence of complete tooth loss was 13.8%. A PSU-level adjustment factor and additional weighting adjustments made nationally representative estimates from the 2017-March 2020 prepandemic data files possible; this was the last NHANES data collected before widespread transmission of COVID-19.