Atlanta—The progress toward meeting national goals to control hypertension in the United States is uneven, at best, with medication use dropping slightly in the most recent years of data from the Behavioral Risk Factor Surveillance System (BRFSS).

An article in the Morbidity & Mortality Weekly Report notes negligible advances—and some declines—in state-level prevalence of hypertension awareness and treatment among U.S. adults during the first half of the current decade. While the age-standardized prevalence of self-reported hypertension decreased slightly, from 30.1% to 29.8% from 2011 to 2015, the prevalence of medication usage actually dropped incrementally from 63.0% to 61.8%.

Those statistics varied by age, sex, race/ethnicity, level of education, and state of residence, point out the researchers from the CDC.

Women (66.8%), adults 65 and older (93.1%), and blacks (60.7%) had a higher prevalence of medication use in 2015, while men (58.5%), adults aged 18–44 years (41.2%), and Hispanics (55.4%) were lower.

“From 2011 to 2015, significant decreases in antihypertensive medication use among persons with self-reported hypertension were observed among both men and women, persons aged ≥65 years, whites, and high school graduates, as well as those with any college education,” the study authors emphasize.

The decrease in the prevalence of medication use was most notable in Connecticut, Hawaii, North Carolina, South Carolina, Texas, Utah, and West Virginia, with the lowest rates, 51.1%, in Idaho. On the other hand, the prevalence of medication use among persons with self-reported hypertension was highest in Louisiana (73.8%). In fact, medication use generally was higher in the Southern states and lower in the Western states.

BRFSS is a state-based telephone survey of noninstitutionalized adults. A report using National Health and Nutrition Examination Survey data found no change in the prevalence of hypertension among U.S. adults, from 1999–2000 (28.4%) to 2011–2012 (28.7%) and 2015–2016 (29.0%).

Study authors point out that other data suggest the trends are going in the right direction. “The finding that the age-standardized prevalence of antihypertensive medication use declined slightly from 2011 (63.1%) to 2015 (61.8%) was unexpected, although the trend in unadjusted prevalence had no meaningful change (from 77.5% to 77.6%),” they write. “A previous study found that hypertension medication prescriptions provided during U.S. physician office visits increased from 69.2% to 78.8% from 2003–2004 to 2009–2010. U.S. prescription sales data also indicated that prescription fill counts for antihypertensive medication increased from 2009 to 2014.”

The researchers add that Healthy People 2020 hypertension targets have yet to be realized, however.
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