Dataset Information

Hypertension Awareness, Treatment, and Control in US Adults: Trends in the Hypertension Control Cascade by Population Subgroup (National Health and Nutrition Examination Survey, 1999-2016).

ABSTRACT: Examination of changes in hypertension awareness, treatment, and control (i.e., the hypertension control cascade) by population subgroup can inform targeted efforts to improve hypertension control and reduce disparities. We analyzed 1999-2016 data from the National Health and Nutrition Examination Survey and examined trends across 6-year periods in hypertension awareness, treatment, and control by age, sex, and race/ethnicity. We included 39,589 participants (16,141 with hypertension). Hypertension awareness, treatment, and control increased from 1999 to 2016 among all age groups. However, there were few changes after 2010. Across all time periods, awareness, treatment, and control were higher among younger women (ages 25-44 years) than among younger men, while control was higher among older men (ages ?65 years) than among older women. Hypertension control was persistently lower for blacks than for whites of all ages, and awareness, treatment, and control were lower among younger Hispanics. There have been few changes in hypertension awareness, treatment, and control since 2010. Disparities in hypertension control by sex highlight the need for effective interventions among younger men and older women. Concerted efforts are also needed to reduce persistent racial/ethnic disparities, particularly to improve treatment control among blacks and to further address gaps at all stages among younger Hispanics.

SUBMITTER: Foti K

PROVIDER: S-EPMC7212399 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Hypertension Awareness, Treatment, and Control in US Adults: Trends in the Hypertension Control Cascade by Population Subgroup (National Health and Nutrition Examination Survey, 1999-2016).

Foti Kathryn K Wang Dan D Appel Lawrence J LJ Selvin Elizabeth E

American journal of epidemiology 20191201 12

Examination of changes in hypertension awareness, treatment, and control (i.e., the hypertension control cascade) by population subgroup can inform targeted efforts to improve hypertension control and reduce disparities. We analyzed 1999-2016 data from the National Health and Nutrition Examination Survey and examined trends across 6-year periods in hypertension awareness, treatment, and control by age, sex, and race/ethnicity. We included 39,589 participants (16,141 with hypertension). Hypertens ...[more]

PMID: 31504121

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Project description:BackgroundThe liver fat score (LFS) has been proposed to be a simple non-invasive marker of non-alcoholic fatty liver disease (NAFLD), which is highly prevalent in the general population. We tested its association with cardiovascular diseases (CVDs) and prognosis.Methods17,244 adult participants from the National Health and Nutrition Examination Survey 1999-2016 were included. LFS is calculated from variables including serum aspartate transaminase/alanine transaminase (AST/ALT) ratio, fasting serum aspartate transaminase (AST) level, fasting serum insulin level, presence of metabolic syndrome and diabetes mellitus. In cross-sectional analysis, logistic regression was used to examine the association of the LFS with coronary heart disease (CHD), myocardial infarction (MI), congestive heart failure (CHF), stroke and angina pectoris. Mortality during follow-up was analysed using Cox proportional hazard regression.ResultsLFS was associated with CHD (adjusted odds ratio [OR]: 1.09 per standard deviation [SD], 95% confidence interval [95% CI]: 1.03-1.15) (p = .003), CHF (1.11, 1.04-1.18) (p = .003) and angina pectoris (1.08, 1.02-1.13) (p = .005). LFS was not associated with MI or stroke, but was associated with increased all-cause and cardiovascular mortality with hazard ratios (HRs) of 1.10 (95% CI: 1.07-1.13) (p < .001) and 1.12 (95% CI: 1.06-1.17) (p < .001), respectively.ConclusionsNAFLD is usually asymptomatic, but this large study of a large general population shows that LFS is associated with CHD, CHF, angina pectoris, cardiovascular and all-cause mortality. Determining the LFS is worthwhile, as it identifies people with NAFLD, who may also be at increased cardiovascular risk.Key MessagesLiver fat score (LFS), a non-invasive marker of non-alcoholic fatty liver disease (NAFLD), is associated with coronary heart disease (CHD), congestive heart failure (CHF) and angina.LFS is also associated with increased cardiovascular and all-cause mortality.Determining the LFS is worthwhile as it identifies people with NAFLD as well as increased cardiovascular risk.

Project description:BackgroundThere are no time trends in prevalence, unawareness, treatment, and control of hypertension in Switzerland. The objective of this study was to analyze these trends and to determine the associated factors.Methods/findingsPopulation-based study conducted in the Canton of Geneva, Switzerland, between 1999 and 2009. Blood pressure was measured thrice using a standard protocol. Hypertension was defined as mean systolic or diastolic blood pressure ? 140/90 mmHg or self-reported hypertension or anti-hypertensive medication. Unawareness, untreated and uncontrolled hypertension was determined by questionnaires/blood pressure measurements. Yearly age-standardized prevalences and adjusted associations for the 1999-2003 and 2004-2009 survey periods were reported. The 10-year survey included 9,215 participants aged 35 to 74 years. Hypertension remained stable (34.4%). Hypertension unawareness decreased from 35.9% to 17.7% (P<0.001). The decrease in hypertension unawareness was not paralleled by a concomitant absolute increase in hypertension treatment, which remained low (38.2%). A larger proportion of all hypertensive participants were aware but not treated in 2004-2009 (43.7%) compared to 1999-2003 (33.1%). Uncontrolled hypertension improved from 62.2% to 40.6% between 1999 and 2009 (P = 0.02). In 1999-2003 period, factors associated with hypertension unawareness were current smoking (OR = 1.27, 95%CI, 1.02-1.59), male gender (OR = 1.56, 1.27-1.92), hypercholesterolemia (OR = 1.31, 1.20-1.44), and older age (OR 65-74 yrs vs 35-49 yrs = 1.56, 1.21-2.02). In 1999-2003 and 2004-2009, obesity and diabetes were negatively associated with hypertension unawareness, high education was associated with untreated hypertension (OR = 1.45, 1.12-1.88 and 1.42, 1.02-1.99, respectively), and male gender with uncontrolled hypertension (OR = 1.49, 1.03-2.17 and 1.65, 1.08-2.50, respectively). Sedentarity was associated with higher risk of hypertension and uncontrolled hypertension in 1999-2003.ConclusionsHypertension prevalence remained stable since 1999 in the canton of Geneva. Although hypertension unawareness substantially decreased, more than half of hypertensive subjects still remained untreated or uncontrolled in 2004-2009. This study identified determinants that should guide interventions aimed at improving hypertension treatment and control.

Dataset Information

Hypertension Awareness, Treatment, and Control in US Adults: Trends in the Hypertension Control Cascade by Population Subgroup (National Health and Nutrition Examination Survey, 1999-2016).

Publications

Hypertension Awareness, Treatment, and Control in US Adults: Trends in the Hypertension Control Cascade by Population Subgroup (National Health and Nutrition Examination Survey, 1999-2016).

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