Increased prevalence of hypertension and use of antihypertensive medications

Almost every state saw a jump in hypertension prevalence from 2005 to 2009.

From 2005 to 2009, self-reported hypertension among U.S. adults increased from 25.8% to 28.3% and use of antihypertensive medications increased from 61.1% to 62.6% among adults reporting hypertension.

These data were based on a CDC analysis of the Behavioral Risk Factor Surveillance System (BRFSS)—a state-based telephone survey assessing the health of adults 18 years or older—and reported in the April 5 Morbidity and Mortality Weekly Report (MMWR).

Prevalence of hypertension and use of antihypertensive medications varied considerably among states. Data for 2009 included the following:

  • Age-adjusted prevalence of hypertension ranged from 20.9% (Minnesota) to 35.9% (Mississippi).
  • Use of antihypertensive drugs ranged from 52.3% (California) to 74.1% (Tennessee). (Of note, from 2005 to 2009, no significant change in reported antihypertensive medication use occurred in Tennessee, while California had a significant increase [48.0% to 52.3%].)

Almost every state saw a jump in hypertension from 2005 to 2009, with increases ranging from 0.2% for Virginia (26.9% to 27.1%) to 7.0% for Kentucky (27.5% to 34.5%). Hypertension and use of antihypertensive medication tended to be higher in southern states and lower in western states (see figure in MMWR report). California, Iowa, and Michigan were among the states showing significant increases in use of antihypertensive medications, whereas Kentucky, Nebraska, and Rhode Island reported significant decreases.

Older individuals (age ≥65 years) had the highest prevalence of self-reported hypertension in 2009 (59.6%), followed by 37.1% among those 45 to 64 years and 13.3% among 18 to 44 year-olds.

Hypertension also was more prevalent in men (30.3%) than women (26.2%) in 2009.

According to race/ethnicity, hypertension was most prevalent among black survey respondents (39.6%), followed by American Indian/Alaska Native (32.0%), Hispanic (27.6%), white (27.1%), and Asian/Pacific Islander (24.0%) respondents.

By education level, those with less than a high school education (33.6%) had the highest percentage of self-reported hypertension, followed by high school education (31.4%), some college (29.2%), and college degree or higher (23.8%).

For antihypertensive medication use among individuals reporting hypertension in 2009, BRFSS data showed the following:

  • Significantly higher prevalence among those 65 years or older (94.1%) compared with those 45 to 64 years (82.3%) and 18 to 44 years (45.1%)
  • Higher use among women (66.9%) than men (59.9%)
  • Higher use among black (71.6%) than Hispanic (55.2%) respondents

CDC noted: "Increased knowledge of the differences in self-reported prevalence of hypertension and use of antihypertensive medications by state can help in guiding programs to prevent heart disease, stroke, and other complications of uncontrolled hypertension, including those conducted by state and local public health agencies and health-care providers."

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