Kershaw V Patel1, Xilong Li2, Nitin Kondamudi1, Muthiah Vaduganathan3, Beverley Adams-Huet2, Gregg C Fonarow4, Wanpen Vongpatanasin1, Ambarish Pandey5. 1. Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas. 2. Division of Biostatistics, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas. 3. Brigham & Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA. 4. Division of Cardiology, Department of Internal Medicine, University of California, Los Angeles, California. 5. Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas. Electronic address: ambarish.pandey@utsouthwestern.edu.
Abstract
OBJECTIVE: To evaluate the prevalence of apparent treatment-resistant hypertension (aTR-hypertension) in US adults with treated hypertension by using the nationally representative National Health and Nutrition Examination Survey (NHANES). PATIENTS AND METHODS: Nonpregnant US adults older than 20 years with a self-reported history of treated hypertension who had blood pressure measured in NHANES cycles 2007 to 2014 were included in this study. Study participants were stratified into 4 groups according to average blood pressure and antihypertensive medication use: well-controlled hypertension, undertreated hypertension, aTR-hypertension by the 2017 guideline, and aTR-hypertension by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guideline. National Health and Nutrition Examination Survey sample weights were used to estimate the national prevalence. RESULTS: From 2007 to 2014, 5512 participants with treated hypertension representing 46.7 million people nationally were included. Compared with JNC 7 guideline criteria, application of the 2017 high blood pressure guideline criteria increased the prevalence of aTR-hypertension in US adults with treated hypertension from 12.0% to 15.95%, identifying an additional 1.85 million individuals with aTR-hypertension nationally. Individuals newly reclassified as having aTR-hypertension were younger. However, the prevalence of thiazide diuretic use remained less than 70%, and that of mineralocorticoid antagonist use remained less than 10% regardless of the guideline definition. CONCLUSION: On the basis of the 2017 high blood pressure guideline, the prevalence of aTR-hypertension is 15.95% in US adults with treated hypertension. This represents an absolute increase of 4% (1.85 million additional individuals nationally) compared with the JNC 7 guideline definition, with a consistent increase across all subpopulations with treated hypertension.
OBJECTIVE: To evaluate the prevalence of apparent treatment-resistant hypertension (aTR-hypertension) in US adults with treated hypertension by using the nationally representative National Health and Nutrition Examination Survey (NHANES). PATIENTS AND METHODS: Nonpregnant US adults older than 20 years with a self-reported history of treated hypertension who had blood pressure measured in NHANES cycles 2007 to 2014 were included in this study. Study participants were stratified into 4 groups according to average blood pressure and antihypertensive medication use: well-controlled hypertension, undertreated hypertension, aTR-hypertension by the 2017 guideline, and aTR-hypertension by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guideline. National Health and Nutrition Examination Survey sample weights were used to estimate the national prevalence. RESULTS: From 2007 to 2014, 5512 participants with treated hypertension representing 46.7 million people nationally were included. Compared with JNC 7 guideline criteria, application of the 2017 high blood pressure guideline criteria increased the prevalence of aTR-hypertension in US adults with treated hypertension from 12.0% to 15.95%, identifying an additional 1.85 million individuals with aTR-hypertension nationally. Individuals newly reclassified as having aTR-hypertension were younger. However, the prevalence of thiazide diuretic use remained less than 70%, and that of mineralocorticoid antagonist use remained less than 10% regardless of the guideline definition. CONCLUSION: On the basis of the 2017 high blood pressure guideline, the prevalence of aTR-hypertension is 15.95% in US adults with treated hypertension. This represents an absolute increase of 4% (1.85 million additional individuals nationally) compared with the JNC 7 guideline definition, with a consistent increase across all subpopulations with treated hypertension.
Authors: Jonnelle M Edwards; Shaunak Roy; Sarah L Galla; Jeremy C Tomcho; Nicole R Bearss; Emily W Waigi; Blair Mell; Xi Cheng; Piu Saha; Matam Vijay-Kumar; Cameron G McCarthy; Bina Joe; Camilla F Wenceslau Journal: Hypertension Date: 2021-03-01 Impact factor: 10.190
Authors: Donald K Hayes; Sandra L Jackson; Yanfeng Li; Gregory Wozniak; Stavros Tsipas; Yuling Hong; Angela M Thompson-Paul; Hilary K Wall; Cathleen Gillespie; Brent M Egan; Matthew D Ritchey; Fleetwood Loustalot Journal: Am J Hypertens Date: 2022-06-16 Impact factor: 3.080