JAMA: More hypertensive patients in control, but no rate decrease

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While the U.S. met the goal of Healthy People 2010 by having 50 percent of hypertensive patients having control over their blood pressure, the overall rates of hypertension are not decreasing, according to a study published May 26 in the Journal of the American Medical Association.

Brent M. Egan, MD, of the Medical University of South Carolina in Charleston, S.C., and colleagues analyzed hypertension trends from the 1988-1994 and 1999-2008 National Health and Nutrition Examination Survey (NHANES) for 42,856 adults over the age of 18 years.

According to the authors, 2005-2006 data showed that hypertension affects almost 65 million people in the U.S.

“Given the prevalence and impact of hypertension on health out­comes and disparities, several na­tional initiatives, developed programs, guidelines and policies to facilitate hy­pertension prevention, detection/awareness, treatment and control,” the authors wrote.

According to the guidelines, patients are diagnosed with hypertension when systolic and diastolic blood pressure is at least 140 mm Hg and 90 mm Hg, respectively. Those who are considered to have their hypertension controlled will have blood pressure less than the aforementioned rates.

Previous NHANES reports showed that the rate of patients whose hypertension were under control were 10 percent between 1976-1980 and raised to 31 percent between 1999-2000.

Egan et al found that between 1988-1994 rates of hypertension increased from 23.9 percent to 28.5 in 1999-2000. However, between 1999-2000 and 2007-2008, the rates of hypertension remained steady at 29 percent.

“Prevalent hy­pertension is not decreasing toward the national goal of 16 percent and will likely re­main high unless adverse trends in popu­lation nutrition and body mass index occur or phar­macological approaches to hypertension prevention are adopted," the authors wrote.

The authors found that the rate of patients diagnosed with hypertension increased from 27.3 percent from 1988-1994 and soared to 50.1 percent during 2007-2008. Also, blood pressure rates for patients diagnosed with hypertension decreased from 143/80.4 mm Hg to 135.2/74.1 mm Hg.

“Better blood pressure control reflected improvements in awareness, treatment, and proportion of patients who were treated and had controlled hypertension,” the authors wrote.

However, the researchers did find that hypertension rates did vary slightly between age, race and sex groups. When comparing patients aged 18 to 39 to those 40 to 49 and 60 years or greater, those reaching optimal hypertension control were lower than other groups.

“Complementary programs to raise awareness and treatment among 18 to 39 years, Hispanic and male groups and to increase the proportion of pa­tients treated and controlled among 60 years or older, black and female groups are important for improving hyperten­sion control and reducing disparities," the authors concluded.