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Trends in Hypertension Prevalence, Awareness, Treatment, and Control in Older U.S. Adults: Data from the National Health and Nutrition Examination Survey 1988 to 2004: TRENDS IN HYPERTENSION

Ostchega, Yechiam; Dillon, Charles F.; Hughes, Jeffery P.; Carroll, Margaret; Yoon, Sarah


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    "description": "OBJECTIVES: To describe hypertension trends in U.S. adults aged 60 and older using National Health and Nutrition Examination Survey (NHANES) data.\n\nSETTING: NHANES III (1988\u20131994) and NHANES 1999 to 2004.\n\nDESIGN: Cross\u2010sectional nationally representative health examination survey.\n\nPARTICIPANTS: Participants in NHANES III (n=5,093) and NHANES 1999 to 2004 (n=4,710).\n\nMEASUREMENTS: Blood pressure (BP).\n\nRESULTS: In 1999 to 2004, 67% of U.S. adults aged 60 and older years were hypertensive, an increase of 10% from NHANES III. Between 1988 to 1994 and 1999 to 2004, hypertension control increased for men from 39% to 51% (P<.05) but remained unchanged for women (35% to 37%; P>.05). Non\u2010Hispanic black men and women had higher prevalences of hypertension than non\u2010Hispanic whites (odds ratio (OR)=2.54, 95% confidence interval (CI)=1.90\u20133.40 and OR=2.07, 95% CI=1.31\u20133.26, respectively), but men were less likely to have controlled BP (OR=0.60, 95% CI=0.41\u20130.86). Mexican\u2010American men and women were less likely than non\u2010Hispanic whites to have controlled BP (OR=0.55, 95% CI=0.33\u20130.91 and OR=0.63, 95% CI=0.40\u20130.98, respectively). Women and men aged 70 and older were significantly less likely to control their hypertension than those aged 60 to 69. In addition, women aged 70 and older were significantly less aware and treated. Having BP measured within 6 months was significantly associated with greater awareness, greater treatment in men and women, and greater control in women. A history of diabetes mellitus or chronic kidney disease (CKD) was significantly associated with less hypertension control.\n\nCONCLUSION: There was a significant increase in hypertension prevalence from 1988 to 2004. Hypertension control continues to be problematic for women, persons aged 70 and older, non\u2010Hispanic blacks and Mexican Americans, and individuals with diabetes mellitus and CKD.", 
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