Factors associated with antihypertensive monotherapy among US adults with treated hypertension and uncontrolled blood pressure overall and by race/ethnicity, National Health and Nutrition Examination Survey 2013-2018 - 28/04/22
, Catherine G. Derington, PharmD, MS b, Jordan B. King, PharmD, MS b, c, Ransmond O. Berchie, MS b, Jennifer S. Herrick, MS b, Dave L. Dixon, PharmD d, Jordana B. Cohen, MD, MSCE e, f, Daichi Shimbo, MD g, Ian M. Kronish, MD, MPH g, Joseph J. Saseen, PharmD h, i, Paul Muntner, PhD j, Andrew E. Moran, MD, MPH k, Adam P. Bress, PharmD, MS bRiassunto |
Background |
Treating hypertension with antihypertensive medications combinations, rather than one medication (ie, monotherapy), is underused in the United States, particularly in certain race/ethnic groups. Identifying factors associated with monotherapy use despite uncontrolled blood pressure (BP) overall and within race/ethnic groups may elucidate intervention targets in under-treated populations.
Methods |
Cross-sectional analysis of National Health and Nutrition Examination Surveys (NHANES; 2013-2014 through 2017-2018). We included participants age ≥20 years with hypertension, taking at least one antihypertensive medication, and uncontrolled BP (systolic BP [SBP] ≥ 140 mmHg or diastolic BP [DBP] ≥ 90 mmHg). Demographic, clinical, and healthcare-access factors associated with antihypertensive monotherapy were determined using multivariable-adjusted Poisson regression.
Results |
Among 1,597 participants with hypertension and uncontrolled BP, age- and sex- adjusted prevalence of monotherapy was 42.6% overall, 45.4% among non-Hispanic White, 31.9% among non-Hispanic Black, 39.6% among Hispanic, and 50.9% among non-Hispanic Asian adults. Overall, higher SBP was associated with higher monotherapy use, while older age, having a healthcare visit in the previous year, higher body mass index, and having heart failure were associated with lower monotherapy use.
Conclusion |
Clinical and healthcare-access factors, including a healthcare visit within the previous year and co-morbid conditions were associated with a higher likelihood of combination antihypertensive therapy.
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Vol 248
P. 150-159 - giugno 2022 Ritorno al numero
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