A larger percentage of Americans with hypertension had their blood pressure under control by the end of 2010 than in 2001, a gain attributed to higher use of multiple drugs to treat the condition. The findings from the study conducted by National Center for Health Statistics, a division of the Centers for Disease Control and Prevention in Hyattsville, Maryland, appears in the journal Circulation.
The team led by Qiuping Gu of National Center for Health Statistics interviewed 9,320 adults in the U.S. with hypertension who took part in the National Health and Nutrition Examination Survey from 2001 to 2010. The survey showed the proportion of U.S. adults with hypertension who had their blood pressure under control increased from three in 10 (29%) in 2001 to nearly half (47%) in 2010.
The results show an increase in those using blood-pressure medication in this population over the decade, from 64 percent in 2001 to 77 percent in 2010. The researchers found a sizable increase in the use of multiple hypertension drugs in this period, from 37 to 48 percent. Single-pill combinations were associated with a 55 percent greater likelihood of controlled blood pressure, as were multiple-pill combinations with a 26 percent likelihood of controlled blood pressure.
American Heart Association, the publisher of the journal, notes that a report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure in 2003 recommended for many patients therapy with two or more drugs to achieve adequate blood pressure control. This study was the first survey of blood pressure medication use since that report. Lower costs and generic forms of blood pressure medications, as well as increased awareness of the risk of uncontrolled high blood pressure, were also credited for the increases in hypertension patients with controlled blood pressure.
Not all of the treatment guidelines were followed closely, however. The guidelines recommended thiazide diuretics as initial drug therapy for most patients with uncomplicated hypertension. Thiazide diuretics decrease the amount of water in the body by increasing urination, thus decreasing body fluid for high blood pressure. However, the results showed only a modest increase in the use of these drugs over the decade, from 22 percent in 2001 to 28 percent in 2010.
Likewise the gains in controlled blood pressure were not uniform across the population. Older Americans, non-Hispanic blacks, people with diabetes, and those with chronic kidney disease still had higher rates of uncontrolled hypertension. In addition, Mexican Americans with hypertension were still less likely to take blood-pressure control drugs than non-Hispanic whites with hypertension.
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