10-Year Community Prevalence and Trends of Severe Asymptomatic Hypertension Among Patients with Hypertension in the USA: 2007-2016

Overview

Journal Int J Cardiol Hypertens

Specialty Cardiology & Vascular Diseases

Date 2021 Jan 15

PMID 33447787

Citations 2

Authors

Muchi Ditah Chobufo

Ebad Ur Rahman

Fatima Farah

Mohamed Suliman

Kanaan Mansoor

Adee Elhamdani

Mehiar El-Hamdani

Sudarshan Balla

Affiliations

Soon will be listed here.

Abstract

Background: Severe asymptomatic hypertension (SAH) is associated with significant health cost, morbidity and mortality.

Aim: Establish the nationwide prevalence, trends and associated sociodemographic characteristics of SAH among patients with hypertension in the USA.

Methods: We utilized the National Health and Nutrition Examination data collected over five survey cycles (2007-2016). Included were participants aged 20-80 years with self-reported diagnosis of hypertension. SAH was defined as having a mean systolic blood pressure (SBP) ≥180 mmHg and/or mean diastolic blood pressure (DBP) ≥120 mmHg at the time of examination. The Chi square test was used to compare prevalence across different categories. Associations between sociodemographic variables and SAH were assessed using multivariate binary logistic regression.

Results: The prevalence of SAH among patients with hypertension is 2.15% (95% CI 1.80-2.56), mainly explained by isolated mean SBP≥180 mmHg (86% of all cases), with no statistically significant change between 2007: 2.66% (95% CI 2.10-3.36) and 2016:2.61% [95% CI 1.73-3.94), p-trend = 0.17. Increasing age (OR 1.07, 95% CI 1.04-1.09), NH Blacks (OR 2.20, 95% CI 1.37-3.54), BMI< 25 (OR 2.52, 95% CI 1.48-4.28), lack of health insurance OR 4.92% (95% CI 2.53-9.54) and never married individuals (OR = 2.59%, 95% CI 1.20-5.60) were more likely to have SAH, comparatively. There was no significant association between duration of hypertension and SAH.

Conclusion: The prevalence of SAH in the USA is 2.15% and has been stable over the past decade. Our study underscores the importance of identifying barriers to screening and treatment of hypertension which is a major treatable risk factor for cardiovascular disease.

Citing Articles

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References

Bender S, Fong M, Heitz S, Bisognano J . Characteristics and management of patients presenting to the emergency department with hypertensive urgency. J Clin Hypertens (Greenwich). 2006; 8(1):12-8. PMC: 8109533. DOI: 10.1111/j.1524-6175.2005.04898.x. View

Kramer B, Kramer R, Benck U, Kruger B . Nonadherence in patients with hypertensive emergency or hypertensive urgency. J Clin Hypertens (Greenwich). 2018; 21(1):64-66. PMC: 8030474. DOI: 10.1111/jch.13442. View

Bennett N, Shea S . Hypertensive emergency: case criteria, sociodemographic profile, and previous care of 100 cases. Am J Public Health. 1988; 78(6):636-40. PMC: 1350272. DOI: 10.2105/ajph.78.6.636. View

Egan B, Zhao Y, Axon R . US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA. 2010; 303(20):2043-50. DOI: 10.1001/jama.2010.650. View

Whelton P, Carey R, Aronow W, Casey Jr D, Collins K, Himmelfarb C . 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on.... Hypertension. 2017; 71(6):e13-e115. DOI: 10.1161/HYP.0000000000000065. View

Overgaauw N, Alsma J, Brink A, Hameli E, Bahmany S, Peeters L . Drug nonadherence is a common but often overlooked cause of hypertensive urgency and emergency at the emergency department. J Hypertens. 2018; 37(5):1048-1057. DOI: 10.1097/HJH.0000000000002005. View

Vidt D . Hypertensive crises: emergencies and urgencies. J Clin Hypertens (Greenwich). 2004; 6(9):520-5. PMC: 8109569. DOI: 10.1111/j.1524-6175.2004.03607.x. View

Tisdale J, Huang M, Borzak S . Risk factors for hypertensive crisis: importance of out-patient blood pressure control. Fam Pract. 2004; 21(4):420-4. DOI: 10.1093/fampra/cmh412. View

Esler M, Lambert G, Schlaich M, Dixon J, Sari C, Lambert E . Obesity Paradox in Hypertension: Is This Because Sympathetic Activation in Obesity-Hypertension Takes a Benign Form?. Hypertension. 2017; 71(1):22-33. DOI: 10.1161/HYPERTENSIONAHA.117.09790. View

10.

GIFFORD Jr R . Management of hypertensive crises. JAMA. 1991; 266(6):829-35. View

11.

Kenrik Duru O, Vargas R, Kermah D, Pan D, Norris K . Health insurance status and hypertension monitoring and control in the United States. Am J Hypertens. 2007; 20(4):348-53. DOI: 10.1016/j.amjhyper.2006.11.007. View

12.

van den Born B, Koopmans R, Groeneveld J, van Montfrans G . Ethnic disparities in the incidence, presentation and complications of malignant hypertension. J Hypertens. 2006; 24(11):2299-304. DOI: 10.1097/01.hjh.0000249710.21146.38. View

13.

Agbor V, Essouma M, Ntusi N, Nyaga U, Bigna J, Noubiap J . Heart failure in sub-Saharan Africa: A contemporaneous systematic review and meta-analysis. Int J Cardiol. 2018; 257:207-215. DOI: 10.1016/j.ijcard.2017.12.048. View

14.

Lim S, Vos T, Flaxman A, Danaei G, Shibuya K, Adair-Rohani H . A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380(9859):2224-60. PMC: 4156511. DOI: 10.1016/S0140-6736(12)61766-8. View

15.

Waldron F, Benenson I, Jones-Dillon S, Zinzuwadia S, Adeboye A, Eris E . Prevalence and risk factors for hypertensive crisis in a predominantly African American inner-city community. Blood Press. 2019; 28(2):114-123. DOI: 10.1080/08037051.2019.1568183. View

16.

Caligiuri S, Austria J, Pierce G . Alarming Prevalence of Emergency Hypertension Levels in the General Public Identified by a Hypertension Awareness Campaign. Am J Hypertens. 2017; 30(3):236-239. PMC: 5861570. DOI: 10.1093/ajh/hpw136. View

17.

Deshmukh A, Kumar G, Kumar N, Nanchal R, Gobal F, Sakhuja A . Effect of Joint National Committee VII report on hospitalizations for hypertensive emergencies in the United States. Am J Cardiol. 2011; 108(9):1277-82. DOI: 10.1016/j.amjcard.2011.06.046. View

18.

Wallbach M, Lach N, Stock J, Hiller H, Mavropoulou E, Chavanon M . Direct assessment of adherence and drug interactions in patients with hypertensive crisis-A cross-sectional study in the Emergency Department. J Clin Hypertens (Greenwich). 2018; 21(1):55-63. PMC: 8030497. DOI: 10.1111/jch.13448. View

19.

Saguner A, Dur S, Perrig M, Schiemann U, Stuck A, Burgi U . Risk factors promoting hypertensive crises: evidence from a longitudinal study. Am J Hypertens. 2010; 23(7):775-80. DOI: 10.1038/ajh.2010.71. View

20.

Chobufo M, Gayam V, Soluny J, Rahman E, Enoru S, Foryoung J . Prevalence and control rates of hypertension in the USA: 2017-2018. Int J Cardiol Hypertens. 2021; 6:100044. PMC: 7803011. DOI: 10.1016/j.ijchy.2020.100044. View