Hardy Shakia T, Jaeger Byron C, Foti Kathryn, Ghazi Lama, Wozniak Gregory, Muntner Paul
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Am J Hypertens. 2025 Jan 16;38(2):120-128. doi: 10.1093/ajh/hpae141.
Prior studies have reported a decrease in the proportion of US adults with hypertension who had controlled blood pressure (BP).
We analyzed data from the National Health and Nutrition Examination Survey (n = 25,128, ≥18 years of age) to determine changes in BP control from 2013-2014 to 2021-2023. Hypertension was defined as systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg, or antihypertensive medication use. BP control was defined as systolic BP <140 mm Hg and diastolic BP <90 mm Hg.
The age-adjusted prevalence of hypertension (95% CI) was 32.8% (31.2%-34.4%) in 2013-2014 and 32.0% (30.1%-33.9%) in 2021-2023. Among US adults with hypertension, the age-adjusted proportion (95% CI) with controlled BP was 54.1% (49.1%-59.2%), 48.6% (44.5%-52.7%), and 48.3% (45.8%-50.8%) in 2013-2014, 2015-2016, and 2017-2020, respectively, (P-trend = 0.058), and 51.1% (47.9%-54.3%) in 2021-2023 (P-value = 0.184 comparing 2021-2023 vs. 2017-2020). The proportion (95% CI) of US adults taking antihypertensive medication with controlled BP was 72.0% (68.5%-75.5%), 66.7% (62.9%-70.5%), and 67.8% (65.3%-70.3%) in 2013-2014, 2015-2016, and 2017-2020, respectively, (P-trend = 0.085), and 68.3% (64.8%-71.9%) in 2021-2023 (P-value = 0.654 comparing 2021-2023 vs. 2017-2020). Among non-Hispanic Black adults, BP control increased from 37.4% (95% CI 33.6%-41.1%) to 49.6% (95% CI 42.3%-56.9%) between 2017-2020 and 2021-2023 for those with hypertension (P-value = 0.005), and from 52.6% (95% CI 47.4%-57.8%) to 62.6% (95% CI 55.6%-69.7%) for those taking antihypertensive medication (P-value = 0.033). There was no difference in BP control across race/ethnicity groups in 2021-2023.
The decline in BP control from 2013-2014 to 2017-2020 did not continue through 2021-2023. An increase in BP control occurred from 2017-2020 and 2021-2023 among non-Hispanic Black adults.
先前的研究报告称，美国患有高血压且血压得到控制的成年人比例有所下降。
我们分析了国家健康与营养检查调查（n = 25128，年龄≥18岁）的数据，以确定2013 - 2014年至2021 - 2023年期间血压控制情况的变化。高血压定义为收缩压≥140毫米汞柱、舒张压≥90毫米汞柱或使用抗高血压药物。血压控制定义为收缩压<140毫米汞柱且舒张压<90毫米汞柱。
2013 - 2014年年龄调整后的高血压患病率（95%置信区间）为32.8%（31.2% - 34.4%），2021 - 2023年为32.0%（30.1% - 33.9%）。在美国患有高血压的成年人中，2013 - 2014年、2015 - 2016年和2017 - 2020年年龄调整后血压得到控制的比例（95%置信区间）分别为54.1%（49.1% - 59.2%）、48.6%（44.5% - 52.7%）和48.3%（45.8% - 50.8%）（P趋势 = 0.058），2021 - 2023年为51.1%（47.9% - 54.3%）（比较2021 - 2023年与2017 - 2020年，P值 = 0.184）。2013 - 2014年、2015 - 2016年和2017 - 2020年服用抗高血压药物且血压得到控制的美国成年人比例（95%置信区间）分别为72.0%（68.5% - 75.5%）、66.7%（62.9% - 70.5%）和67.8%（65.3% - 70.3%）（P趋势 = 0.085），2021 - 2023年为68.3%（64.8% - 71.9%）（比较2021 - 2023年与2017 - 2020年，P值 = 0.654）。在非西班牙裔黑人成年人中，2017 - 2020年至2021 - 2023年期间，患有高血压者的血压控制率从37.4%（95%置信区间33.6% - 41.1%）增至49.6%（95%置信区间42.3% - 56.9%）（P值 = 0.005），服用抗高血压药物者的血压控制率从52.6%（95%置信区间47.4% - 57.8%）增至62.6%（95%置信区间55.6% - 69.7%）（P值 = 0.033）。2021 - 2023年各种族/族裔群体的血压控制情况无差异。
2013 - 2014年至2017 - 2020年期间血压控制率的下降在2021 - 2023年没有持续。2017 - 2020年至2021 - 2023年期间，非西班牙裔黑人成年人的血压控制率有所上升。
