Differences in Hypertension Prevalence and Hypertension Control by Urbanization Among Adults in the United States, 2013-2018

Am J Hypertens. 2022 Jan 5;35(1):31-41. doi: 10.1093/ajh/hpab067.

Abstract

Background: To examine the associations between urbanization and hypertension, stage II hypertension, and hypertension control.

Methods: Data on 16,360 US adults aged 18 years or older from the 2013-2018 National Health and Nutrition Examination Survey (NHANES) were used to estimate the prevalence of hypertension (blood pressure (BP) ≥130/80 mm Hg or use of medication for hypertension), stage II hypertension (BP ≥140/90 mm Hg), and hypertension control (BP <130/80 mm Hg among hypertensives) by urbanization, classified by levels of metropolitan statistical areas as large MSAs (population ≥1,000,000), medium to small MSAs (population 50,000-999,999), and non-MSAs (population <50,000).

Results: All prevalence ratios (PRs) were compared with large MSAs and adjusted for demographics and risk factors. The PRs of hypertension were 1.07 (95% confidence interval (CI) = 0.99-1.14) for adults residing in medium to small MSAs and 1.06 (95% CI = 0.99-1.13) for adults residing in non-MSAs. For stage II hypertension, the PRs were higher for adults residing in medium to small MSAs 1.21 (95% CI = 1.06-1.36) but not for adults residing in non-MSAs 1.06 (95% CI = 0.88-1.29). For hypertension control, the PRs were 0.96 (95% CI = 0.91-1.01) for adults residing in medium to small MSAs and 1.00 (95% CI = 0.93-1.06) for adults residing in non-MSAs.

Conclusions: Among US adults, urbanization was associated with stage II hypertension.

Keywords: NHANES; blood pressure; hypertension; hypertension control; hypertension stage II; urbanization.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Blood Pressure
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / drug therapy
  • Hypertension* / epidemiology
  • Nutrition Surveys
  • Prevalence
  • Risk Factors
  • United States / epidemiology
  • Urbanization*