Prevalence Of Antihypertensive Medication Use Research Articles

RESIDENCE AT HIGH ALTITUDE IS ASSOCIATED WITH LOWER CONVENTIONAL AND AMBULATORY BLOOD PRESSURE THAN LIVING AT SEA LEVEL IN THE GENERAL POPULATION OF PERU. HIGHCARE-LAPS STUDY

Objective: Acute exposure to hypoxia at high altitude (HA) leads to an increase in blood pressure (BP) in healthy individuals and in hypertensive patients. Little is known, however, about the effect of long-term HA residence on BP. Available data based on conventional BP measurements are inconsistent and no general population studies using 24-h ambulatory BP monitoring (ABPM) have been conducted. Aim of HIGHCARE-LAPS was to compare BP levels and cardiovascular risk profile among population-based samples of subjects residing in Peruvian communities living at different altitudes. BP-related data are reported in this paper. Design and method: Study participants were recruited by sex- and age-stratified random multistage cluster sampling from the general adult population residing permanently in urban areas at different altitudes in Peru (Lima, <500m, Huancayo 3287m, Juliaca 3824m, Cerro de Pasco 4330m). In all participants questionnaire-based information, conventional BP (3 seated measurements with a validated oscillometric device, HEM7121 OMRON, Japan), 24-hour ambulatory BP (A&D TM2430, Japan) and laboratory variables were obtained. Results: The study included 206 lowlanders and 595 highlanders. Highlanders were slightly younger, had lower BMI, oxygen saturation and prevalence of antihypertensive medication use and higher haematocrit. In highlanders all conventional and ambulatory BP values were lower and heart rate values higher than in lowlanders. Comparisons between lowlander and highlander samples and for individual sites at different altitudes are reported in the Table. The difference in 24-hour systolic BP between highlanders and lowlanders remained significant (7.2 mmHg, p<0.001) in a linear multiple regression model adjusting for age, sex, BMI, 24-hour heart rate, respiratory rate, and haematocrit. These covariates were selected by LASSO method from a set also including lifestyle-related variables. Conclusions: Permanent residence at high altitude is independently associated with lower conventional and ambulatory BP levels than low altitude residence in the general population of Peru. This relationship does not seem to be explained by lifestyle differences. Mechanisms behind this difference and its impact on cardiovascular risk should be further investigated. Also, comparative studies with other highland populations with different adaptive characteristics would allow to understand better the effects of HA residence on cardiovascular health.

Prevalence of Self-Reported Hypertension and Antihypertensive Medication Use Among Adults - United States, 2017-2021.

Hypertension, or high blood pressure, is a major risk factor for heart disease and stroke. It increases with age and is highest among non-Hispanic Black or African American persons, men, persons aged ≥65 years, those of lower socioeconomic status, and those who live in the southern United States. Hypertension affects approximately one half of U.S. adults, and approximately one quarter of those persons have their blood pressure under control. Reducing population-level hypertension prevalence and improving control is a national priority. In 2017, updated guidelines for high blood pressure in adults recommended lowering the blood pressure threshold for diagnosis of hypertension. Analysis of data from the Behavioral Risk Factor Surveillance System found that age-standardized, self-reported diagnosed hypertension was approximately 30% during 2017-2021, with persistent differences by age, sex, race and ethnicity, level of education, and state of residence. During this period, the age-standardized prevalence of antihypertensive medication use among persons with hypertension increased by 3.1 percentage points, from 59.8% to 62.9% (p<0.001). Increases in antihypertensive medication use were observed in most sociodemographic groups and in many states. Assessing current trends in hypertension diagnosis and treatment can help guide the development of policies and implementation of interventions to reduce this important risk factor for cardiovascular disease and can aid in addressing health disparities.

PCR150 Effects of Smoking on the Prevalence of Self-Reported Antihypertensive Medication Use Among Community-Dwelling Stroke Survivors

To evaluate the effects of cigarette smoking on the prevalence of antihypertensive medication use among community-dwelling stroke survivors.

Effect of Age on Hypertension Recognition in Children With Chronic Kidney Disease: A Report From the Chronic Kidney Disease in Children Study.

Young age has been associated with poorer control of hypertension in children with chronic kidney disease (CKD). Using data from the CKiD Study (Chronic Kidney Disease in Children), we examined the relationship between age, hypertensive blood pressure (BP) recognition, and pharmacologic BP control in children with nondialysis-dependent CKD. Participants included 902 CKiD Study participants with CKD stages 2 to 4. A total of 3550 annual study visits met inclusion criteria and participants were stratified by age (0 to <7, ≥7 to <13, ≥13 to ≤18 years). Generalized estimating equations to account for repeated measures were applied to logistic regression analyses to evaluate the association of age with unrecognized hypertensive BP and medication use. Children <7 years of age had a higher prevalence of hypertensive BP and a lower prevalence of antihypertensive medication use compared with older children. At visits where participants <7 years of age had hypertensive BP readings, 46% had unrecognized, untreated hypertensive BP compared with 21% of visits for children ≥13 years of age. The youngest age group was associated with higher odds of unrecognized hypertensive BP (adjusted odds ratio, 2.11 [95% CI, 1.37-3.24]) and lower odds of antihypertensive medication use among those with unrecognized hypertensive BP (adjusted OR, 0.51 [95% CI, 0.27-0.996]). Children younger than 7 years of age with CKD are more likely to have both undiagnosed and undertreated hypertensive BP. Efforts to improve BP control in young children with CKD are needed to minimize development of cardiovascular disease and slow CKD progression.

Antihypertensive Medications Use among Chronic Hemodialysis Patients Visiting the Outpatient Department of Nephrology of a Tertiary Care Centre: A Descriptive Cross-sectional Study

Anti-hypertensive medications are prescribed for the management of high blood pressure which is the leading cause of mortality in chronic hemodialysis patients. The objective of our study was to find out the prevalence of anti-hypertensive medication use among chronic hemodialysis patients visiting the outpatient Department of Nephrology of a tertiary care centre. This was a descriptive cross-sectional study conducted among chronic hemodialysis patients visiting the Department of Nephrology of a tertiary care centre from 2 April 2022 to 30 September 2022. Ethical approval was taken from the Institutional Review Committee (Reference number: 062-078/079). A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. The prevalence of anti-hypertensive medications use was present in 102 (97.14%) (93.95-100, 95% Confidence Interval) patient undergoing hemodialysis. The three common drugs prescribed for hypertensive patients were amlodipine 79 (77.45%), torsemide 59 (57.84%), and prazosin 48 (47.05%). The prevalence of antihypertensive medication use among patients undergoing hemodialysis was higher than other similar studies done in similar settings. anti-hypertensive drugs; hemodialysis; prevalence.

Self-Reported Prevalence of Hypertension and Antihypertensive Medication Use Among Asian Americans: Behavioral Risk Factor Surveillance System 2013, 2015 and 2017.

Asian Americans are one of the fastest growing races in the US. The objectives of this report were to assess self-reported hypertension prevalence and treatment among Asian Americans. Merging 2013, 2015, and 2017 Behavioral Risk Factor Surveillance System data, we estimated self-reported hypertension and antihypertensive medication use among non-Hispanic Asian Americans (NHA) and compared estimates between NHA and non-Hispanic whites (NHW), and by NHA subgroup (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese/other). The prevalence of hypertension was 20.8% and 33.5%, respectively, for NHAs and NHWs (p < 0.001). Among those with hypertension, the prevalence of antihypertensive medication use was 71.6% and 78.2%, respectively, for NHAs and NHWs (p < 0.001). Among NHA subgroups, a wide range of hypertension prevalence and medication use was found. Overall NHA had a lower reported prevalence of hypertension and use of antihypertensive medication than NHW. Certain NHA subgroups had a burden comparable to high-risk disparate populations.

Prevalence of Self-Reported Hypertension and Antihypertensive Medication Use by County and Rural-Urban Classification - United States, 2017.

In 2017, approximately one in three U.S. adults reported having been told by a health care professional that they had high blood pressure (hypertension) (1). Although hypertension prevalence is well documented at national and state levels, less is known about rural-urban variation and county-level prevalence. To examine prevalence of self-reported hypertension and antihypertensive medication use by rural-urban classification and county, CDC analyzed data reported by 442,641 adults aged ≥18 years who participated in the 2017 Behavioral Risk Factor Surveillance System (BRFSS). In rural (noncore) areas, 40.0% (unadjusted prevalence) of adults reported having hypertension, whereas in the most urban (large central metro) areas, 29.4% reported having hypertension. Age-standardized hypertension prevalence was significantly higher in the most rural areas, compared with the most urban areas within nearly all categories of age, sex, and other demographic characteristics. Model-based hypertension prevalence across counties ranged from 18.0% to 55.0% and was highest in Southeastern* and Appalachian† counties. Model-based county-level prevalence of antihypertensive medication use among adults with hypertension ranged from 54.3% to 84.7%. Medication use also was higher in rural areas compared with use in most urban areas, with prevalence highest in Southeastern and Appalachian counties as well as counties in the Dakotas and Nebraska. CDC is working with states to enhance hypertension awareness and management through a strategy of team-based care that involves physicians, nurses, pharmacists, dietitians, and community health workers. The increased use of telemedicine to support this strategy might improve access to care among underserved populations.

Prevalence of Self-Reported Hypertension and Antihypertensive Medication Use Among Adults - United States, 2017.

Hypertension, or high blood pressure, is a major risk factor for heart disease and stroke (1). The prevalence of hypertension is higher among men than among women, increases with age, is highest among non-Hispanic blacks (blacks) (2), and has been consistently highest in the Southeastern region of the United States (1). To update prevalence estimates for self-reported hypertension and use of antihypertensive medication, CDC analyzed data from the 2017 Behavioral Risk Factor Surveillance System (BRFSS). The overall (unadjusted) prevalence of self-reported hypertension was 32.4% (95% confidence interval [CI]=32.1%-32.7%). The age-standardized, median state-specific prevalence of self-reported hypertension was 29.7% (range=24.3%-38.6%). Overall age-standardized hypertension prevalence was higher among men (32.9%) than among women (27.0%), highest among blacks (40.0%), decreased with increasing levels of education and household income, and was generally highest in the Southeastern and Appalachian states.* Among persons reporting hypertension, the overall unadjusted prevalence of self-reported antihypertensive medication use was 76.0% (95% CI=75.5%-76.4%). The age-standardized, median state-specific prevalence of antihypertensive medication use among persons with reported hypertension was 59.4% (range=50.2%-71.2%). Prevalence was higher among women than men, highest among blacks compared with other racial/ethnic groups, and highest among states in the Southeast, Appalachia, and the Dakotas. These findings can help inform CDC's initiatives to enhance hypertension awareness, treatment, and control across all states.

No difference in medication regimes and dosing in study participants with and without blood pressure control: longitudinal data of the population-based Heinz Nixdorf Recall Study.

To achieve blood pressure (BP) control adequate dosing of first-line antihypertensive medications is recommended in addition to life-style changes. Given observations that dosing of antihypertensive agents is frequently insufficient, we compared the changes of BP control rates and antihypertensive drug regimens in a prospective German population using a new strategy to analyze medication dosing. This analysis is based on data of the baseline (2000-2003) and the first follow-up examination (2005-2008) of the population-based Heinz Nixdorf Recall study. Participants with hypertension at baseline (BP ≥140/90 mmHg or at least one antihypertensive agent) who participated in both examinations were included. Of the 4157 participants, 2289 (55.1%) had hypertension at baseline. The prevalence of participants on antihypertensive agents was 60.3% at baseline and increased to 75.1% at follow-up. The mean number of antihypertensive agents was 2 [±1 SD (standard deviation)] initially and at follow-up. The prevalence of medication-controlled BP did not improve over time (baseline: 54.5%, follow-up: 56.5%). When stratifying by medication-controlled BP, the medication dosing rate slightly increased over time without differences between groups [controlled versus uncontrolled BP: 40.9 versus 46.2% (baseline); 50.1 versus 51.9% (follow-up)]. Although the prevalence of antihypertensive medication use increased in the study period, the BP control rate did not. In contrast to clinical reasoning, participants with uncontrolled BP did neither receive more agents nor higher dosing despite outcome-relevant hypertension. Our approach to analyze medication dosing suggests a potential to improve cardiovascular outcomes by increasing dosages of antihypertensive agents.

Gender differences in hypertension awareness, antihypertensive use and blood pressure control in Nepalese adults: findings from a nationwide cross-sectional survey.

The objective of this cross-sectional study was to determine the gender differences in hypertension awareness, antihypertensive use and blood pressure (BP) control among the adult Nepalese population (≥18 years) using data from the nationally representative Nepal Demographic and Health Survey 2016. A weighted sample of 13,393 adults (5620 males and 7773 females) was included in the final analysis. After conducting descriptive analyses with the selective explanatory variable, multivariable logistic regression analysis was performed to assess the association between the outcome variable and the explanatory variables. The strength of the association was expressed in adjusted odds with 95% confidence intervals. A higher proportion of women had their BP checked (87.7% females vs 73.0% males, p<0.001) and were aware of their raised BP (43.9% females vs 37.1% males, p<0.001) compared with men. Although female hypertensive individuals had a higher prevalence of antihypertensive medication use than their male counterparts (50.1% females vs 47.5% males), a higher proportion of male hypertensive participants had their BP controlled (49.2% females vs 53.5% males). Women with the poorest wealth index had a lower prevalence of antihypertensive use than their male counterparts. The odds of having their own BP measured increased with age among men but decreased with age among women. The household wealth index was positively associated with the odds of BP measurement, awareness of own BP and antihypertensive use. This study revealed that although women had a higher prevalence of hypertension awareness and antihypertensive medication use, the practice did not translate into better BP control. Inequality in antihypertensive medication use was observed among the poorest wealth quintiles. Public health programmes in Nepal should focus on reducing these inequalities. Further research is needed to learn why females have poorer control of BP, despite having higher antihypertensive medication use.

Prevalence of Self-Reported Hypertension and Antihypertensive Medication Use Among Adults Aged ≥18 Years - United States, 2011-2015.

Hypertension, which affects nearly one third of adults in the United States, is a major risk factor for heart disease and stroke (1), and only approximately half of those with hypertension have their hypertension under control (2). The prevalence of hypertension is highest among non-Hispanic blacks, whereas the prevalence of antihypertensive medication use is lowest among Hispanics (1). Geographic variations have also been identified: a recent report indicated that the Southern region of the United States had the highest prevalence of hypertension as well as the highest prevalence of medication use (3). Using data from the Behavioral Risk Factor Surveillance System (BRFSS), this study found minimal change in state-level prevalence of hypertension awareness and treatment among U.S. adults during the first half of the current decade. From 2011 to 2015, the age-standardized prevalence of self-reported hypertension decreased slightly, from 30.1% to 29.8% (p = 0.031); among those with hypertension, the age-standardized prevalence of medication use also decreased slightly, from 63.0% to 61.8% (p<0.001). Persistent differences were observed by age, sex, race/ethnicity, level of education, and state of residence. Increasing hypertension awareness, as well as increasing hypertension control through lifestyle changes and consistent antihypertensive medication use, requires diverse clinical and public health intervention.

Abstract P258: Antihypertensive Medication Nonadherence Among Hispanic Adults by Healthcare Access and Acculturation Characteristics - Estilos Survey, 2015

Medication adherence for hypertensive adults (HTNs) is an important factor in achieving and maintaining blood pressure control, as it has been associated with better health outcomes and lower costs of medical care. We assessed the differences in the prevalence of self-reported antihypertensive medication use and adherence among Hispanic HTNs by selected characteristics. Methods: ESTILOS is an online panel for health survey data of Hispanic adults in the USA. In 2015, 1,000 adults completed the survey with a response rate of 29%. The resulting data were weighted using 8 factors: gender, age, household income, household size, education, census region, country of origin, and acculturation (based on years living in the USA, language spoken at home, cultural self-identification, and use of Spanish language). The differences among characteristics for prevalence ± standard error of medication use and adherence were compared by using χ 2 statistics. Results: The prevalence of hypertension was 27.5±2.7%. The prevalence of antihypertensive medication use in HTNs was 67.9±4.6%) overall and was higher among those ≥55 years of age (95.2±2.1%; P =&lt;0.0001), retirees (92.3±4.0%; P =0.0002), who had healthcare coverage (72.5±4.8%; P =0.02) and had a primary care physician (PCP) (71.9±4.9%; P =0.03), did not have any reported cost barriers to seeing their PCP within past 12 months (71.9±5.3%; P =0.001), and took 3-4 lifestyle actions (79.7±5.4%; P =0.015) than &lt;3 lifestyle actions). Among HTNs taking antihypertensives, 24.0±7.0% reported missing or skipping medication doses. HTNs aged &lt;55 years or who could not see a PCP within the past year due to cost barriers, were more likely to miss or skip doses of antihypertensive medication (&lt;55=54.1±13.4%) vs &gt;55=11.5±5.3%; P =0.03 and could not see PCP=45.2±12.1% vs 12.0±5.2%; 0.01, respectively). Conclusion: Poor antihypertensive medication adherence among Hispanics with hypertension was associated with younger age groups and those who reported barriers to engaging with a PCP. Public health practitioners and clinicians can utilize this information to support their programs and can tailor strategies for improved outcomes.

Trends in Antihypertensive Medication Use and Blood Pressure Control Among United States Adults With Hypertension

Background— The monitoring of national trends in hypertension treatment and control can provide important insight into the effectiveness of primary prevention efforts for cardiovascular disease. The objective of this study was to examine recent trends in antihypertensive medication use and its impact on blood pressure control among US adults with hypertension. Methods and Results— A total of 9320 hypertensive people aged ≥18 years from the National Health and Nutrition Examination Survey 2001 to 2010 were included in this study. The prevalence of antihypertensive medication use increased from 63.5% in 2001 to 2002 to 77.3% in 2009 to 2010 ( P trend &lt;0.01). Most notably, there was a large increase in the use of multiple antihypertensive agents (from 36.8% to 47.7%, P trend &lt;0.01). Overall, the use of thiazide diuretics, β-blockers, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers increased by 23%, 57%, 31%, and 100%, respectively. In comparison with monotherapy, single-pill combinations and multiple-pill combinations were associated with 55% and 26% increased likelihoods of blood pressure control, respectively. By the 2009 to 2010 time period, 47% of all hypertensive people and 60% of treated hypertensive people had blood pressure controlled. However, higher treated but uncontrolled hypertension rates continued to persist among older Americans, non-Hispanic blacks, diabetic people, and those with chronic kidney disease. Also, Mexican Americans with hypertension were still less likely to take antihypertensive medication than non-Hispanic whites with hypertension. Conclusions— Antihypertensive medication use and blood pressure control among US adults with hypertension significantly increased over the past 10 years. Combination therapy regimens can facilitate achievement of blood pressure goals.

都市部男性勤務者の32年間の身体所見の推移

In Japan, there is growing concern that employees' health condition has been worsening under the severe labor conditions of the continuing recent deep recession. To determine trends in the prevalence of cardiovascular risk factors among employees, we analyzed 32 yr of systematic surveillance of urban Japanese employed men. The surveyed population included male employees aged 40 to 59 yr who worked for four companies, a trading company, two banks and a company maintaining expressways in Osaka. Surveillance of cardiovascular risk factors was conducted from 1977 to 2008. We examined the annual mean values of systolic blood pressure, diastolic blood pressure, body mass index, and total serum cholesterol, and the prevalence of hypertension, obesity, hypercholesterolemia, smoking, alcohol drinkers, and high risk individuals who had two or more risk factors: (high blood pressure, high glucose and dyslipidemia). The total number of employees aged 40-59 yr increased from 822 in 1977 to 2,651 in 1992, but then declined gradually to 1,455 in 2008. Among men aged 40-49 and 50-59, the prevalence of hypertension decreased from 25% and 39% in 1977 to 14% and 23% in 1992, respectively. However, the respective prevalence of hypertension started to rise thereafter to 29% and 47% in 2008, accompanied by an increase in blood pressure levels and the prevalence of antihypertensive medication use. Mean body mass index and the prevalence of obesity showed significant upward linear trends from the mid-1980's to 2008. Therefore, we speculate that the increase in blood pressure levels seen after the early 1990's associated with an increase in obesity. However the proportion of hypertension among non-overweight men also increased between the early 1990's and 2008, suggesting other factors are also involved in the increase of hypertension. The prevalence of hypercholesterolemia and high-risk individuals with obesity also increased in recent years. Mean total cholesterol level showed a linear increase from 195 mg/dl for men aged 40-49 and 196 mg/dl for men aged 50-59 in 1977 to 204 mg/dl and 207 mg/dl in 2008, respectively. The prevalence of high-risk individuals with obesity was 13% for men aged 40-49 and 15% for men aged 50-59 in 2008. Among men aged 50-59, the prevalence of non-overweight high-risk individuals became higher than that of high-risk individuals with obesity over time. Although these findings were limited to the study companies, our data support evidence that Japanese employees have become increasingly at risk of cardiovascular diseases under the severe working conditions experienced since the 1990's. It is important to improve working conditions as well as personally control risk factors from the point of public health.

Gender Differences in Hypertension Treatment, Drug Utilization Patterns, and Blood Pressure Control Among US Adults With Hypertension: Data From the National Health and Nutrition Examination Survey 1999-2004

National guidelines recommend the same approach for treating hypertensive men and women. It is not known, however, whether current US antihypertensive medication utilization patterns and the resulting degrees of blood pressure (BP) control are similar or different among hypertensive women and men. The study was a cross-sectional, nationally representative survey of the noninstitutionalized civilian US population. Persons aged > or =18 years from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 were classified as hypertensive based on a BP > or =140/90 mm Hg, currently taking antihypertensive medication, or having been diagnosed by a physician. Among hypertensives, the prevalence of antihypertensive medication use was significantly higher among women than men (61.4% vs. 56.8%), especially among middle-aged persons (40-49 years, 53.1% vs. 42.7%) and among non-Hispanic blacks (65.5% vs. 54.6%). Also, treated women were more likely than men to use diuretics (31.6% vs. 22.3%) and angiotensin receptor blockers (11.3% vs. 8.7%). Among treated hypertensives, the proportion taking three or more antihypertensive drugs was lower among women than men, especially among older persons (60-69 years: 12.3% vs. 19.8%, 70-79 years: 18.6% vs. 21.2%, and > or =80 years: 18.8% vs. 22.8%). Only 44.8% of treated women achieved BP control vs. 51.1% of treated men. Hypertensive women are significantly more likely to be treated than men, but less likely to have achieved BP control. Additional efforts may be needed to achieve therapeutic goals for the US hypertensive population, especially for hypertensive women.