Trends in Prehypertension and Hypertension Risk Factors in US Adults: 1999-2012.
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ABSTRACT:
SUBMITTER: Booth JN
PROVIDER: S-EPMC5594566 | biostudies-literature | 2017 Aug
REPOSITORIES: biostudies-literature
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Trends in Prehypertension and Hypertension Risk Factors in US Adults: 1999-2012.
Booth John N JN Li Jiexiang J Zhang Lu L Chen Liwei L Muntner Paul P Egan Brent B
Hypertension (Dallas, Tex. : 1979) 20170612 2
Prehypertension is associated with increased risk for hypertension and cardiovascular disease. Data are limited on the temporal changes in the prevalence of prehypertension and risk factors for hypertension and cardiovascular disease among US adults with prehypertension. We analyzed data from 30 958 US adults ≥20 years of age who participated in the National Health and Nutrition Examination Surveys between 1999 and 2012. Using the mean of 3 blood pressure (BP) measurements from a study examinati ...[more]
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Project description:ImportanceDietary supplements are commonly used by US adults; yet, little is known about recent trends in supplement use.ObjectiveTo report trends in dietary supplement use among US adults.Design, setting, and participantsSerial cross-sectional study using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) collected between 1999 and 2012. Participants include noninstitutionalized adults residing in the United States, surveyed over 7 continuous 2-year cycles (sample size per cycle, 4863 to 6213).ExposuresCalendar time, as represented by NHANES cycle.Main outcomes and measuresIn an in-home interview, participants were queried on use of supplements in the preceding 30 days to estimate the prevalence of use within each NHANES cycle, and trends were evaluated across cycles. Outcomes included use of any supplements; use of multivitamins/multiminerals (MVMM; defined as a product containing ≥10 vitamins and/or minerals); and use of individual vitamins, minerals, and nonvitamin, nonmineral supplements. Data were analyzed overall and by population subgroup (including age, sex, race/ethnicity, and educational status), and were weighted to be nationally representative.ResultsA total of 37 958 adults were included in the study (weighted mean age, 46.4 years; women, 52.0% ), with an overall response rate of 74%. Overall, the use of supplements remained stable between 1999 and 2012, with 52% of US adults reporting use of any supplements in 2011-2012 (P for trend = .19). This trend varied by population subgroup. Use of MVMM decreased, with 37% reporting use of MVMM in 1999-2000 and 31% reporting use in 2011-2012 (difference, -5.7% [95% CI, -8.6% to -2.7%], P for trend < .001). Vitamin D supplementation from sources other than MVMM increased from 5.1% to 19% (difference, 14% [95% CI, 12% to 17%], P for trend < .001) and use of fish oil supplements increased from 1.3% to 12% (difference, 11% [95% CI, 9.1% to 12%], P for trend < .001) over the study period, whereas use of a number of other supplements decreased.Conclusions and relevanceAmong adults in the United States, overall use of dietary supplements remained stable from 1999-2012, use of MVMM decreased, and trends in use of individual supplements varied and were heterogeneous by population subgroups.
| S-EPMC5540241 | biostudies-literature
Project description:It is important to document patterns of prescription drug use to inform both clinical practice and research.To evaluate trends in prescription drug use among adults living in the United States.Temporal trends in prescription drug use were evaluated using nationally representative data from the National Health and Nutrition Examination Survey (NHANES). Participants included 37,959 noninstitutionalized US adults, aged 20 years and older. Seven NHANES cycles were included (1999-2000 to 2011-2012), and the sample size per cycle ranged from 4861 to 6212.Calendar year, as represented by continuous NHANES cycle.Within each NHANES cycle, use of prescription drugs in the prior 30 days was assessed overall and by drug class. Temporal trends across cycles were evaluated. Analyses were weighted to represent the US adult population.Results indicate an increase in overall use of prescription drugs among US adults between 1999-2000 and 2011-2012 with an estimated 51% of US adults reporting use of any prescription drugs in 1999-2000 and an estimated 59% reporting use of any prescription drugs in 2011-2012 (difference, 8% [95% CI, 3.8%-12%]; P for trend <.001). The prevalence of polypharmacy (use of ?5 prescription drugs) increased from an estimated 8.2% in 1999-2000 to 15% in 2011-2012 (difference, 6.6% [95% CI, 4.4%-8.2%]; P for trend <.001). These trends remained statistically significant with age adjustment. Among the 18 drug classes used by more than 2.5% of the population at any point over the study period, the prevalence of use increased in 11 drug classes including antihyperlipidemic agents, antidepressants, prescription proton-pump inhibitors, and muscle relaxants.In this nationally representative survey, significant increases in overall prescription drug use and polypharmacy were observed. These increases persisted after accounting for changes in the age distribution of the population. The prevalence of prescription drug use increased in the majority of, but not all, drug classes.
| S-EPMC4752169 | biostudies-other
Project description:BackgroundThis study aimed to describe the prevalence and risk factors of prehypertension and hypertension in Jiangxi Province, China. Individuals with prehypertension frequently progress into hypertension and are at high risk of developing cardiovascular disease and stroke.MethodsA cross-sectional survey of 15,296 participants (15 years or older) was conducted in Jiangxi Province, China, in 2013, using questionnaire forms and physical measurements.ResultsThe prevalence of prehypertension and hypertension was 32.3% (39.2% in men and 27.6% in women) and 29.0% (30.1% in men and 28.2% in women), respectively. The awareness, treatment, and control rates among all hypertensive participants were 64.8%, 27.1%, and 12.6%, respectively. The prevalence of prehypertension in males declined with age, but the prevalence of hypertension increased in different genders. The prevalence of prehypertension and hypertension increased with increasing body mass index (BMI). The prevalence of prehypertension decreased, in parallel to an increase in the prevalence of hypertension, with increasing waist circumference (WC). A combination of WC and BMI was superior to individual indices in identifying hypertension. A multivariate logistic regression analysis indicated that increasing age, high BMI, high visceral adipose index, and high heart rate were risk factors for prehypertension and hypertension. The high body fat percentage was significantly associated with prehypertension. Living in an urban area, male sex, abdominal obesity, and menopause were correlated with hypertension.ConclusionsPrehypertension and hypertension are epidemic in southern China. Further studies are needed to explore an indicator that can represent the visceral fat accurately and has a close relationship with cardiovascular disease.
| S-EPMC5240940 | biostudies-literature
Project description:ImportanceMost studies of US dietary trends have evaluated major macronutrients or only a few dietary factors. Understanding trends in summary measures of diet quality for multiple individual foods and nutrients, and the corresponding disparities among population subgroups, is crucial to identify challenges and opportunities to improve dietary intake for all US adults.ObjectiveTo characterize trends in overall diet quality and multiple dietary components related to major diseases among US adults, including by age, sex, race/ethnicity, education, and income.Design, setting, and participantsRepeated cross-sectional investigation using 24-hour dietary recalls in nationally representative samples including 33,932 noninstitutionalized US adults aged 20 years or older from 7 National Health and Nutrition Examination Survey (NHANES) cycles (1999-2012). The sample size per cycle ranged from 4237 to 5762.ExposuresCalendar year and population sociodemographic subgroups.Main outcomes and measuresSurvey-weighted, energy-adjusted mean consumption and proportion meeting targets of the American Heart Association (AHA) 2020 continuous diet scores, AHA score components (primary: total fruits and vegetables, whole grains, fish and shellfish, sugar-sweetened beverages, and sodium; secondary: nuts, seeds, and legumes, processed meat, and saturated fat), and other individual food groups and nutrients.ResultsSeveral overall dietary improvements were identified (P < .01 for trend for each). The AHA primary diet score (maximum of 50 points) improved from 19.0 to 21.2 (an improvement of 11.6%). The AHA secondary diet score (maximum of 80 points) improved from 35.1 to 38.5 (an improvement of 9.7%). Changes were attributable to increased consumption between 1999-2000 and 2011-2012 of whole grains (0.43 servings/d; 95% CI, 0.34-0.53 servings/d) and nuts or seeds (0.25 servings/d; 95% CI, 0.18-0.34 servings/d) (fish and shellfish intake also increased slightly) and to decreased consumption of sugar-sweetened beverages (0.49 servings/d; 95% CI, 0.28-0.70 servings/d). No significant trend was observed for other score components, including total fruits and vegetables, processed meat, saturated fat, or sodium. The estimated percentage of US adults with poor diets (defined as <40% adherence to the primary AHA diet score components) declined from 55.9% to 45.6%, whereas the percentage with intermediate diets (defined as 40% to 79.9% adherence to the primary AHA diet score components) increased from 43.5% to 52.9%. Other dietary trends included increased consumption of whole fruit (0.15 servings/d; 95% CI, 0.05-0.26 servings/d) and decreased consumption of 100% fruit juice (0.11 servings/d; 95% CI, 0.04-0.18 servings/d). Disparities in diet quality were observed by race/ethnicity, education, and income level; for example, the estimated percentage of non-Hispanic white adults with a poor diet significantly declined (53.9% to 42.8%), whereas similar improvements were not observed for non-Hispanic black or Mexican American adults. There was little evidence of reductions in these disparities and some evidence of worsening by income level.Conclusions and relevanceIn nationally representative US surveys conducted between 1999 and 2012, several improvements in self-reported dietary habits were identified, with additional findings suggesting persistent or worsening disparities based on race/ethnicity, education level, and income level. These findings may inform discussions on emerging successes, areas for greater attention, and corresponding opportunities to improve the diets of individuals living in the United States.
| S-EPMC6287627 | biostudies-literature
Project description:Globally, complications of raised blood pressure are fundamental public health issues. There has been limited research if prevalence and risk factors vary by sex in many countries, including Bangladesh. We stratified the prevalence and associated factors of prehypertension and hypertension according to sex in Bangladesh. This cross-sectional study analyzed the Bangladesh Demographic and Health Survey 2011 data. After estimating prevalence according to sex, multilevel logistic regression was applied to obtain associated factors. This study analyzed data of 3876 males and 3962 females aged ≥35 years. The prevalence of hypertension was 19.4% (95% confidence interval [CI]: 18.0-21.0) among males and 31.9% (95% CI: 30.1-33.6) among females. Among both males and females, prevalence and odds of hypertension increased with age, overweight/obesity, diabetes, upper wealth status, and residence in some divisions. Education level was a significant positive correlate of hypertension for males only. Males and females had similar prevalence of prehypertension, 27.2% (95% CI: 25.6-28.8) and 27.6% (95% CI: 26.0-29.2), respectively. Characteristics such as older age, overweight/obesity, and diabetes were associated with higher prevalence and odds of prehypertension among females; prehypertension among males was associated with advancing age, overweight/obesity, education level, wealth status, and division of residence. In Bangladesh, almost half of the males and females could have increased risks of complications resulting from hypertension and prehypertension. Addressing the characteristics associated with higher prevalence or odds of these conditions is crucial. Several common risk factors indicate that a common prevention and control strategy could work for both sexes.
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Project description:ObjectiveWe aimed to describe the trends and influence factors in the prevalence, awareness, treatment, and control of hypertension among US Adults from 1999 to 2018.MethodsWe 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.ResultsThe 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.ConclusionAlthough 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.
| S-EPMC10538741 | biostudies-literature
Project description:ImportanceUnderstanding population-wide trends in prevalence and control of diabetes is critical to planning public health approaches for prevention and management of the disease.ObjectiveTo determine trends in prevalence of diabetes and control of risk factors in diabetes among US adults between 1999-2000 and 2017-2018.Design, setting, and participantsTen cycles of cross-sectional National Health and Nutrition Examination Survey (NHANES) data between 1999-2000 and 2017-2018 were included. The study samples were weighted to be representative of the noninstitutionalized civilian resident US population. Adults aged 18 years or older were included, except pregnant women.ExposuresSurvey cycle.Main outcomes and measuresDiabetes was defined by self-report of diabetes diagnosis, fasting plasma glucose level of 126 mg/dL or more, or hemoglobin A1c (HbA1c) level of 6.5% or more. Three risk factor control goals were individualized HbA1c targets, blood pressure less than 130/80 mm Hg, and low-density lipoprotein cholesterol level less than 100 mg/dL. Prevalence of diabetes and proportion of adults with diagnosed diabetes who achieved risk factor control goals, overall and by sociodemographic variables, were estimated.ResultsAmong the 28 143 participants included (weighted mean age, 48.2 years; 49.3% men), the estimated age-standardized prevalence of diabetes increased significantly from 9.8% (95% CI, 8.6%-11.1%) in 1999-2000 to 14.3% (95% CI, 12.9%-15.8%) in 2017-2018 (P for trend < .001). From 1999-2002 to 2015-2018, the estimated age-standardized proportion of adults with diagnosed diabetes who achieved blood pressure less than 130/80 mm Hg (P for trend = .007) and low-density lipoprotein cholesterol level less than 100 mg/dL (P for trend < .001) increased significantly, but not individualized HbA1c targets (P for trend = .51). In 2015-2018, 66.8% (95% CI, 63.2%-70.4%), 48.2% (95% CI, 44.6%-51.8%), and 59.7% (95% CI, 54.2%-65.2%) of adults with diagnosed diabetes achieved individualized HbA1c targets, blood pressure less than 130/80 mm Hg, and low-density lipoprotein cholesterol level less than 100 mg/dL, respectively. Only 21.2% of these adults (95% CI, 15.5%-26.8%) achieved all 3. During the entire study period, these 3 goals were significantly less likely to be achieved among young adults aged 18 to 44 years (vs older adults ≥65 years: estimated proportion, 7.4% vs 21.7%; adjusted odds ratio, 0.32 [95% CI, 0.16-0.63]), non-Hispanic Black adults (vs non-Hispanic White adults: estimated age-standardized proportion, 12.5% vs 20.6%; adjusted odds ratio, 0.60 [95% CI, 0.40-0.90]), and Mexican American adults (vs non-Hispanic White adults: estimated age-standardized proportion, 10.9% vs 20.6%; adjusted odds ratio, 0.48 [95% CI, 0.31-0.77]).Conclusions and relevanceBased on NHANES data from US adults, the estimated prevalence of diabetes increased significantly between 1999-2000 and 2017-2018. Only an estimated 21% of adults with diagnosed diabetes achieved all 3 risk factor control goals in 2015-2018.
| S-EPMC8233946 | biostudies-literature
Project description:ImportanceAfter decades of decline, the US cardiovascular disease mortality rate flattened after 2010, and racial and ethnic differences in cardiovascular disease mortality persisted.ObjectiveTo examine 20-year trends in cardiovascular risk factors in the US population by race and ethnicity and by socioeconomic status.Design, setting, and participantsA total of 50 571 participants aged 20 years or older from the 1999-2018 National Health and Nutrition Examination Surveys, a series of cross-sectional surveys in nationally representative samples of the US population, were included.ExposuresCalendar year, race and ethnicity, education, and family income.Main outcomes and measuresAge- and sex-adjusted means or proportions of cardiovascular risk factors and estimated 10-year risk of atherosclerotic cardiovascular disease were calculated for each of 10 two-year cycles.ResultsThe mean age of participants ranged from 49.0 to 51.8 years and the proportion of women from 48.2% to 51.3% in the surveys. From 1999-2000 to 2017-2018, age- and sex-adjusted mean body mass index increased from 28.0 (95% CI, 27.5-28.5) to 29.8 (95% CI, 29.2-30.4); mean hemoglobin A1c increased from 5.4% (95% CI, 5.3%-5.5%) to 5.7% (95% CI, 5.6%-5.7%) (both P < .001 for linear trends). Mean serum total cholesterol decreased from 203.3 mg/dL (95% CI, 200.9-205.8 mg/dL) to 188.5 mg/dL (95% CI, 185.2-191.9 mg/dL); prevalence of smoking decreased from 24.8% (95% CI, 21.8%-27.7%) to 18.1% (95% CI, 15.4%-20.8%) (both P < .001 for linear trends). Mean systolic blood pressure decreased from 123.5 mm Hg (95% CI, 122.2-124.8 mm Hg) in 1999-2000 to 120.5 mm Hg (95% CI, 119.6-121.3 mm Hg) in 2009-2010, then increased to 122.8 mm Hg (95% CI, 121.7-123.8 mm Hg) in 2017-2018 (P < .001 for nonlinear trend). Age- and sex-adjusted 10-year atherosclerotic cardiovascular disease risk decreased from 7.6% (95% CI, 6.9%-8.2%) in 1999-2000 to 6.5% (95% CI, 6.1%-6.8%) in 2011-2012, then did not significantly change. Age- and sex-adjusted body mass index, systolic blood pressure, and hemoglobin A1c were consistently higher, while total cholesterol was lower in non-Hispanic Black participants compared with non-Hispanic White participants (all P < .001 for group differences). Individuals with college or higher education or high family income had consistently lower levels of cardiovascular risk factors. The mean age- and sex-adjusted 10-year risk of atherosclerotic cardiovascular disease was significantly higher in non-Hispanic Black participants compared with non-Hispanic White participants (difference, 1.4% [95% CI, 1.0%-1.7%] in 1999-2008 and 2.0% [95% CI, 1.7%-2.4%] in 2009-2018]). This difference was attenuated (-0.3% [95% CI, -0.6% to 0.1%] in 1999-2008 and 0.7% [95% CI, 0.3%-1.0%] in 2009-2018) after further adjusting for education, income, home ownership, employment, health insurance, and access to health care.Conclusions and relevanceIn this serial cross-sectional survey study that estimated US trends in cardiovascular risk factors from 1999 through 2018, differences in cardiovascular risk factors persisted between Black and White participants; the difference may have been moderated by social determinants of health.
| S-EPMC8493438 | biostudies-literature
Project description:ImportanceControlling blood pressure (BP) reduces the risk for cardiovascular disease.ObjectiveTo determine whether BP control among US adults with hypertension changed from 1999-2000 through 2017-2018.Design, setting, and participantsSerial cross-sectional analysis of National Health and Nutrition Examination Survey data, weighted to be representative of US adults, between 1999-2000 and 2017-2018 (10 cycles), including 18 262 US adults aged 18 years or older with hypertension defined as systolic BP level of 140 mm Hg or higher, diastolic BP level of 90 mm Hg or higher, or use of antihypertensive medication. The date of final data collection was 2018.ExposuresCalendar year.Main outcomes and measuresMean BP was computed using 3 measurements. The primary outcome of BP control was defined as systolic BP level lower than 140 mm Hg and diastolic BP level lower than 90 mm Hg.ResultsAmong the 51 761 participants included in this analysis, the mean (SD) age was 48 (19) years and 25 939 (50.1%) were women; 43.2% were non-Hispanic White adults; 21.6%, non-Hispanic Black adults; 5.3%, non-Hispanic Asian adults; and 26.1%, Hispanic adults. Among the 18 262 adults with hypertension, the age-adjusted estimated proportion with controlled BP increased from 31.8% (95% CI, 26.9%-36.7%) in 1999-2000 to 48.5% (95% CI, 45.5%-51.5%) in 2007-2008 (P < .001 for trend), remained stable and was 53.8% (95% CI, 48.7%-59.0%) in 2013-2014 (P = .14 for trend), and then declined to 43.7% (95% CI, 40.2%-47.2%) in 2017-2018 (P = .003 for trend). Compared with adults who were aged 18 years to 44 years, it was estimated that controlled BP was more likely among those aged 45 years to 64 years (49.7% vs 36.7%; multivariable-adjusted prevalence ratio, 1.18 [95% CI, 1.02-1.37]) and less likely among those aged 75 years or older (37.3% vs 36.7%; multivariable-adjusted prevalence ratio, 0.81 [95% CI, 0.65-0.97]). It was estimated that controlled BP was less likely among non-Hispanic Black adults vs non-Hispanic White adults (41.5% vs 48.2%, respectively; multivariable-adjusted prevalence ratio, 0.88; 95% CI, 0.81-0.96). Controlled BP was more likely among those with private insurance (48.2%), Medicare (53.4%), or government health insurance other than Medicare or Medicaid (43.2%) vs among those without health insurance (24.2%) (multivariable-adjusted prevalence ratio, 1.40 [95% CI, 1.08-1.80], 1.47 [95% CI, 1.15-1.89], and 1.36 [95% CI, 1.04-1.76], respectively). Controlled BP was more likely among those with vs those without a usual health care facility (48.4% vs 26.5%, respectively; multivariable-adjusted prevalence ratio, 1.48 [95% CI, 1.13-1.94]) and among those who had vs those who had not had a health care visit in the past year (49.1% vs 8.0%; multivariable-adjusted prevalence ratio, 5.23 [95% CI, 2.88-9.49]).Conclusions and relevanceIn a series of cross-sectional surveys weighted to be representative of the adult US population, the prevalence of controlled BP increased between 1999-2000 and 2007-2008, did not significantly change from 2007-2008 through 2013-2014, and then decreased after 2013-2014.
| S-EPMC7489367 | biostudies-literature
Project description:PurposePulmonary hypertension (PH) is a heterogenous, often progressive disorder leading to right heart failure and death. Previous analyses show stable PH mortality rates from 1980 to 2001 but increasing from 2001 to 2010 especially among women and non-Hispanic (NH) Black. This study seeks to identify recent trends in PH mortality in the United States from 1999 to 2019.MethodsMortality rates among individuals more than or equal to 15 years of age were obtained from the Centers for Disease Control and Prevention's (CDC) Wide-Ranging Online Data for Epidemiology Research (WONDER) database. ICD-10 codes were used to identify individuals with PH.ResultsBetween 1999 and 2019, PH was included as a cause on 429,105 recorded deaths. The average age-adjusted PH mortality rate was 7.9 per 100,000 individuals and increased by 1.9% per year. Higher age-adjusted mortality rates were experienced by females and NH Black persons. The crude mortality rate was 105.4 per 100,000 among those decedents 85 or older. From 1999 to 2019, mortality in PH and left heart disease co-occurrence increased at nearly double the annual rate of the overall PH group.ConclusionsDespite therapeutic advances for selected PH subgroups, the overall age-adjusted PH mortality rate increased significantly from 1999 to 2019 and previously reported racial disparities have persisted. These findings emphasize the need for additional study to improve outcomes in PH.
| S-EPMC9709717 | biostudies-literature