Inadequate control of hypertension in US adults with cardiovascular disease comorbidities in 2003-2004.
BACKGROUND
Cardiovascular risks associated with hypertension (HTN) and the importance of its control are well established; however, the prevalence and adequacy of its treatment and control in persons with cardiovascular comorbidities (CVCs) are uncertain.


METHODS
To examine the prevalence, treatment, and control of HTN among US adults with and without CVCs, we analyzed data from adults at least 18 years of age (n = 4646, N [projected sample size] = 192.4 million) in the National Health and Nutrition Examination Survey 2003-2004, a nationally representative cross-sectional survey of the noninstitutionalized civilian US population. Prevalence, treatment, and control rates of HTN in patients with CVCs vs those without, including coronary artery disease, congestive heart failure, stroke, chronic kidney disease, peripheral artery disease, and diabetes mellitus, and distance to blood pressure goal in those whose HTN was not controlled were the main outcomes.


RESULTS
The overall prevalence rate of HTN was 31.4% (n = 1671, N = 60.5 million), ranging from 23.1% in those without CVCs to 51.8% to 81.8% in those with CVCs (P < .01). Despite HTN treatment rates for diabetes mellitus, stroke, heart failure, and coronary artery disease that are higher (83.4%-89.3%) than the rates of those without these conditions (66.5%) (P < .01), control rates for treatment remained poor (23.2%-49.3%) (P < .001 to P = .048). Isolated systolic HTN was the most common hypertensive subtype in those with CVCs (> or = 63.5%) with systolic blood pressure averaging at least 20 mm Hg from goal.


CONCLUSIONS
Nearly three-fourths of adults with CVCs have HTN. Poor control rates of systolic HTN remain a principal problem that further compromises their already high cardiovascular disease risk.
Wong
Nathan D
ND
Heart Disease Prevention Program, Department of Medicine, University of California, C240 Medical Sciences, Irvine, CA 92697, USA. ndwong@uci.edu
Lopez
Victor A
VA
L'Italien
Gilbert
G
Chen
Roland
R
Kline
Sue Ellen J
SE
Franklin
Stanley S
SS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D003327:Coronary Disease / Q000150:complications* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D000959:Antihypertensive Agents