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Uncontrolled and Apparent Treatment Resistant Hypertension in the United States, 1988 to 2008
- Source :
- J Clin Hypertens (Greenwich)
- Publication Year :
- 2011
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2011.
-
Abstract
- Background— Despite progress, many hypertensive patients remain uncontrolled. Defining characteristics of uncontrolled hypertensives may facilitate efforts to improve blood pressure control. Methods and Results— Subjects included 13 375 hypertensive adults from National Health and Nutrition Examination Surveys (NHANESs) subdivided into 1988 to 1994, 1999 to 2004, and 2005 to 2008. Uncontrolled hypertension was defined as blood pressure ≥140/≥90 mm Hg and apparent treatment-resistant hypertension (aTRH) when subjects reported taking ≥3 antihypertensive medications. Framingham 10-year coronary risk was calculated. Multivariable logistic regression was used to identify clinical characteristics associated with untreated, treated uncontrolled on 1 to 2 blood pressure medications, and aTRH across all 3 survey periods. More than half of uncontrolled hypertensives were untreated across surveys, including 52.2% in 2005 to 2008. Clinical factors linked with untreated hypertension included male sex, infrequent healthcare visits (0 to 1 per year), body mass index 2 , absence of chronic kidney disease, and Framingham 10-year coronary risk P P P 20% ( P Conclusion— Untreated, undertreated, and aTRH patients have consistent characteristics that could inform strategies to improve blood pressure control by decreasing untreated hypertension, reducing therapeutic inertia in undertreated patients, and enhancing therapeutic efficiency in aTRH.
- Subjects :
- Male
Risk
medicine.medical_specialty
Departments
Population
Drug Resistance
Comorbidity
Logistic regression
Body Mass Index
Physiology (medical)
Internal medicine
Epidemiology
Prevalence
medicine
Humans
Obesity
education
Treatment resistant
Antihypertensive Agents
education.field_of_study
Framingham Risk Score
business.industry
Middle Aged
Nutrition Surveys
medicine.disease
United States
Blood pressure
Hypertension
Physical therapy
Female
Kidney Diseases
Cardiology and Cardiovascular Medicine
business
Body mass index
Subjects
Details
- ISSN :
- 15244539 and 00097322
- Volume :
- 124
- Database :
- OpenAIRE
- Journal :
- Circulation
- Accession number :
- edsair.doi.dedup.....5707683eba653cb39c3de446cf4c6885