未控制的高血压是美国心血管疾病(CVD)的主要原因。
■为了确定高血压控制级联结果的患病率(高血压意识,治疗建议,和药物使用)在患有不受控制的高血压的个体中,以告知跨级联水平的行动。
这项加权横断面研究使用了2017年1月至2020年3月美国18岁或以上未住院的高血压患者的国家健康和营养检查调查(NHANES)数据。数据分析发生在2024年1月至2月。
■对NHANES调查的响应日历年。
■使用多达3次测量计算平均血压(BP)。未控制的高血压定义为收缩压130mmHg或更高或舒张压80mmHg或更高。无论药物使用。结果包括患者对高血压的认识,治疗建议,和药物使用。要按亚组估计人口总数,每个结局的年龄标准化比例乘以未受控制的高血压成年人的估计人数.
■该研究包括3129名患有未控制的高血压的美国成年人(1675名男性[加权百分比,52.3%];775名18至44岁[加权百分比,29.4%];1306名45至64岁[加权百分比,41.4%];1048岁以上65岁[加权百分比,29.2%]),导致人口估计为1.004亿成年人(加权百分比,83.7%)伴有未控制的高血压。超过一半的研究参与者(5780万成年人[加权百分比,57.6%])不知道他们患有高血压,在知道并符合抗高血压药物标准的3,500万人中,2480万(加权百分比,70.8%)服用了药物,但高血压仍未控制。高血压控制级联中的这些负面结果发生在人口统计学群体中,在年轻人和从事医疗保健的个人中,患病率尤其高。在估计的3010万18至44岁的高血压成年人中,1,130万女性中的10.4(加权百分比,91.8%)和1880万男性中的1770万(加权百分比,94.3%)患有未控制的高血压。在1040万女性中,720万(加权百分比,68.8%)不知道他们的高血压状况,在1770万男性中,1,200万(加权百分比,68.1%)不知情。此外,1300万患有未控制的高血压的成年人中有9.9人(加权百分比,75.7%)报告在过去一年中没有进行医疗保健访问,并且没有意识到。相反,在报告2次或更多医疗保健访问的70.6百万未控制的高血压成年人中,大约一半(3660万[加权百分比,51.8%])不知情。
■在这项横断面研究中,在美国,超过50%的未控制高血压的成年人没有意识到他们的高血压,并且未经治疗,接受治疗的患者中有70.8%的高血压仍未得到控制。鉴于高血压与CVD风险增加的关系,这些发现对国家的整体健康具有严重影响。
UNASSIGNED: Uncontrolled hypertension is a major contributor to cardiovascular disease (CVD) in the US.
UNASSIGNED: To determine the prevalence of hypertension control cascade outcomes (hypertension awareness, treatment recommendations, and medication use) among individuals with uncontrolled hypertension to inform action across cascade levels.
UNASSIGNED: This weighted cross-sectional study used January 2017 to March 2020 National Health and Nutrition Examination Survey (NHANES) data from noninstitutionalized adults aged 18 years or older in the US with uncontrolled hypertension. Data analysis occurred from January to February 2024.
UNASSIGNED: Calendar year of response to the NHANES survey.
UNASSIGNED: Mean blood pressure (BP) was computed using up to 3 measurements. Uncontrolled hypertension was defined as systolic BP of 130 mm Hg or greater or diastolic BP of 80 mm Hg or greater, regardless of medication use. Outcomes included patient awareness of hypertension, treatment recommendations, and medication use. To estimate population totals by subgroup, the age-standardized proportion of each outcome was multiplied by the estimated number of adults with uncontrolled hypertension.
UNASSIGNED: The study included 3129 US adults with uncontrolled hypertension (1675 male [weighted percentage, 52.3%]; 775 aged 18 to 44 years [weighted percentage, 29.4%]; 1306 aged 45 to 64 years [weighted percentage, 41.4%]; 1048 aged 65 years or older [weighted percentage, 29.2%]), resulting in a population estimate of 100.4 million adults (weighted percentage, 83.7%) with uncontrolled hypertension. More than one-half of study participants (57.8 million adults [weighted percentage, 57.6%]) were unaware that they had hypertension, and of the 35.0 million who were aware and met criteria for antihypertensive medication, 24.8 million (weighted percentage, 70.8%) took the medication but had hypertension that remained uncontrolled. These negative outcomes in the hypertension control cascade occurred across demographic groups, with notably high prevalence among younger adults and individuals engaged in health care. Among an estimated 30.1 million adults aged 18 to 44 years with hypertension, 10.4 of 11.3 million females (weighted percentage, 91.8%) and 17.7 million of 18.8 million males (weighted percentage, 94.3%) had uncontrolled hypertension. Of the 10.4 million females, 7.2 million (weighted percentage, 68.8%) were unaware of their hypertension status, and of the 17.7 million males, 12.0 million (weighted percentage, 68.1%) were unaware. Additionally, 9.9 of 13.0 million adults with uncontrolled hypertension (weighted percentage, 75.7%) reported no health care visits in the past year and were unaware. Conversely, among 70.6 million adults with uncontrolled hypertension reporting 2 or more health care visits, approximately one-half (36.6 million [weighted percentage, 51.8%]) were unaware.
UNASSIGNED: In this cross-sectional study, more than 50% of adults with uncontrolled hypertension in the US were unaware of their hypertension and were untreated, and 70.8% of those who were treated had hypertension that remained uncontrolled. These findings have serious implications for the nation\'s overall health given the association of hypertension with increased risk for CVD.