Trends and influence factors in the prevalence, awareness, treatment, and control of hypertension among US adults from 1999 to 2018

Zhixing Fan; Chaojun Yang; Jing Zhang; Yifan Huang; Ying Yang; Ping Zeng; Wanyin Cai; Zujin Xiang; Jingyi Wu; Jian Yang

doi:10.1371/journal.pone.0292159

Trends and influence factors in the prevalence, awareness, treatment, and control of hypertension among US adults from 1999 to 2018

PLoS One. 2023 Sep 28;18(9):e0292159. doi: 10.1371/journal.pone.0292159. eCollection 2023.

Authors

Zhixing Fan^{1

2

3}, Chaojun Yang^{1

2}, Jing Zhang^{1

2}, Yifan Huang^{1

2}, Ying Yang^{1

2}, Ping Zeng^{1

2}, Wanyin Cai^{1

2}, Zujin Xiang^{1

2}, Jingyi Wu^{1

2}, Jian Yang^{1

2}

Affiliations

¹ Department of Cardiology, the First College of Clinical Medical Sciences, China Three Gorges University, Yichang, China.
² Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, China.
³ Department of Medical Record Management, the First College of Clinical Medical Sciences, China Three Gorges University, Yichang, China.

Abstract

Objective: We aimed to describe the trends and influence factors in the prevalence, awareness, treatment, and control of hypertension among US Adults from 1999 to 2018.

Methods: We utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning ten survey cycles (n = 53,496). Prevalence, awareness, treatment, and control of hypertension were calculated using survey weights. Joinpoint regression and survey-weighted generalized linear models were used to analyze trends and influence factors, respectively.

Results: The estimated prevalence of hypertension increased significantly from 33.53% to 40.58% (AAPC = 0.896, P = 0.002) during 1999-2018 with dropping rate of newly diagnosed hypertension from 8.62% to 4.82% before 2014 (APC = -4.075, P = 0.001), and then rose to 7.51% in 2018 (APC = 12.302, P = 0.126). Despite modest improvements or stability in the awareness, treatment, and control since 1999, the latter two remained inadequate in 2018 at 59.52% and 51.71%. There was an uptrend in the use of angiotensin-converting enzyme inhibitors (from 24.02% to 45.71%) and angiotensin receptor blockers (from 20.22% to 38.38%), and downtrend in β-blocker (from 12.71% to 4.21%). Men were at higher risk of incidence, un-awareness, un-treatment, and un-control for hypertension. Lower income and education were associated with susceptibility to hypertension, while being married was favorable for treatment and control. Optimal health reduced the incidence of hypertension, and increased the awareness and treatment.

Conclusion: Although the rate of newly diagnosed hypertension has declined slightly since 2010 in the US, the prevalence of hypertension is increasing, and treatment and control rates remain inadequate. To manage hypertension effectively, we need to focus on screening and prevention for high-risk populations, while advocating for optimal health to improve the burden of hypertension.

Copyright: © 2023 Fan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Antihypertensive Agents / therapeutic use
Awareness
Health Knowledge, Attitudes, Practice
Humans
Hypertension* / drug therapy
Hypertension* / epidemiology
Hypertension* / prevention & control
Linear Models
Male
Nutrition Surveys
Prevalence
Risk Factors

Substances

Antihypertensive Agents

Grants and funding

This research was supported by the National Natural Science Foundation of China (No. 82371597, 81800258, 82271618), supported by the Natural Science Foundation of Hubei Province (2023AFB609) and supported by Health Commission of Hubei Province (WJ2023M150).