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Healthy People 2010 goal for hypertension control achieved in 2008

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Patients with hypertension demonstrated improved hypertension control from 27.3% in between 1994 and 2008, study findings indicated.

The analysis of data from the National Health and Nutritional Examination Survey (NHANES) from 1988-1994 and 1999-2008 included 42,856 adults aged >18 years. Researchers selected volunteers using stratified, multistage probability sampling of the noninstitutionalized United States population. The definition of hypertension was a systolic BP of ≥140 mm Hg and diastolic BP of ≥90 mm Hg, self-reported use of antihypertensive medications, or both. Control of hypertension was defined as systolic BP values of <140 mm Hg and diastolic BP values of <90 mm Hg. Survey periods were age-adjusted to the United States population in year 2000.

Hypertension control increased from 27.3% (95% CI, 25.6-29.1) in 1988-1994 to 50.1% (95% CI, 46.8-53.5) in 2007-2008, but was lower among individuals aged 18 to 39 years vs. older participants aged 40 to 59 years (P<.001), as well as those aged 60 years and older (P<.001). BP control was also lower in Hispanics vs. white individuals (P=.004). Both systolic and diastolic BP among patients with hypertension decreased between the 1988-1994 survey period and the 2007-2008 survey period (systolic change, P<.001; diastolic change P=.02).

“Hypertension control improved, despite adverse changes in nutrition and BMI, and reflects increases in awareness, treatment and patients who were treated attaining target BP,” the researchers reported. “Complementary programs to raise awareness and treatment among [those aged] 18 to 39 years; Hispanic and male groups; and to increase the proportion of patients treated and controlled among [those] 60 years or older, black and female groups are important for improving hypertension control and reducing disparities.” – by Brian Ellis

Egan B. JAMA. 2010; 303(20):2043-2050.

In general, the results of the this study represent a report card of how our country is doing with regard to achieving BP goals. This report card is contrary to the Institute of Medicines allegation that we are not doing a good job in controlling BP. Admittedly the 50% goal was set by Healthy People 2000 and was not achieved. Eight years later, we have achieved (and to a small extent, have exceeded) this goal. This is a very positive sign that will translate into fewer strokes and CV events in general.

– George Bakris, MD

Cardiology Today Editorial Board