HealthDay News — Antihypertensive medication use and blood pressure control are increasing among U.S. adults, but racial disparities still exist, study results suggest.
The number of patients using multiple agents to control their BP jumped from 36.8% in 2001 to 47.7% in 2010 (P<0.01), Qiuping Gu, MD, PhD, of the CDC’s National Center for Health Statistics in Hyattsville, Md., and colleagues reported in Circulation.
Patients on combination therapy with either a single pill or multi-pill regimen have a 55% and 26% relative increase, respectively, in the likelihood of achieving BP control compared with those on monotherapy (P<0.05 for both).
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“The value of using multiple antihypertensive drugs [is that it] improves the overall efficacy of drugs, reduces dose-dependent side effects, and increases patients’ adherence to medication regimens,” the researchers wrote.
They assessed recent trends in antihypertensive medication use and its impact on BP control in a cohort of 9,320 hypertensive adults, aged 18 years or older, who participated in the National Health and Nutrition Examination Survey (NHANES) 2001 to 2010.
Hypertension was defined as a systolic blood pressure of 140 mm Hg or higher, a diastolic pressure of 90 mm Hg or higher, or an answer of yes to the question, “Because of your hypertension/high blood pressure are you now taking prescribed medicine?”
Systolic BP less than 140 mm Hg and diastolic pressure of less than 90 mm Hg was considered controlled, or a systolic BP of less than 130 mm Hg and a diastolic pressure of less than 80 mm Hg for patients with diabetes or chronic kidney disease.
The researchers found that, from 2001-2002 to 2009-2010, the prevalence of antihypertensive medication use increased from 63.5% to 77.3% (P<0.01), and multiple antihypertensive agent use increased from 36.8% to 47.7 %. Use of thiazide diuretics, beta-blockers, ACE inhibitors, and angiotensin receptor blockers increased by a relative 23%, 57%, 31%, and 100%, respectively, whereas use of calcium channel blockers remained relatively steady.
By 2009 to 2010, blood pressure was controlled in 47% of all people with hypertension and 60% of treated individuals with hypertension. However, rates of uncontrolled hypertension were still high for older Americans, blacks, individuals with diabetes and those with chronic kidney disease.
Mexican-Americans with hypertension were also less likely to be taking antihypertensive medication than their non-Hispanic white counterparts.
“More efforts are needed to close the gap between treatment and control and to maximize the public health and clinical benefits among those high-risk subpopulations,” the researchers wrote.
