TY - JOUR
T1 - Prevalence of Apparent Treatment-Resistant Hypertension in the United States According to the 2017 High Blood Pressure Guideline
AU - Patel, Kershaw V.
AU - Li, Xilong
AU - Kondamudi, Nitin
AU - Vaduganathan, Muthiah
AU - Adams-Huet, Beverley
AU - Fonarow, Gregg C.
AU - Vongpatanasin, Wanpen
AU - Pandey, Ambarish
N1 - Funding Information:
Grant Support: The work was supported by the T32 postdoctoral training grant 5T32HL125247-03 (K.V.P.)from the National Heart, Lung, and Blood Institute; by grants R01 AG05757 and R01 HL133179 (W.V.)from the Norman and Audrey Kaplan Chair in Hypertension and the Pak Center of Mineral Metabolism and Clinical Research; and by the Texas Health Resources Clinical Scholarship (A.P.).
Publisher Copyright:
© 2019 Mayo Foundation for Medical Education and Research
PY - 2019/5
Y1 - 2019/5
N2 - 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.
AB - 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.
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U2 - 10.1016/j.mayocp.2018.12.033
DO - 10.1016/j.mayocp.2018.12.033
M3 - Article
C2 - 31054605
AN - SCOPUS:85064665713
SN - 0025-6196
VL - 94
SP - 776
EP - 782
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
IS - 5
ER -