Trends in Blood Pressure Control and Use of Hypertension Medications

According to Mohamed Taher, MD, and colleagues, there  has been a worsening trend in blood pressure control in the United States over the past decade; a trend that was exacerbated by the COVID-19 pandemic.

During a poster session at the NKF Spring Clinical Meetings 2023, the researchers reported on a previously validated method to quantify hypertension daily dose (HDD) equivalents for each antihypertensive medication class to enable estimation of a mean HDD that can cumulatively quantify dose intensity across all hypertension medication classes. The poster was titled Hypertension Medications Daily Dose Usage Trend and Blood Pressure Control from 2012-2020 in a Large US Health System.

The analysis utilized electronic health record data from a  health system in central/northeast Pennsylvania (Geisinger). Blood pressure control was determined using the mean of all outpatient blood pressure readings for each patient year. To determine whether mean total HDD and blood pressure control <140/90 mm Hg changed over time from 2012 to 2020, the researchers used multilevel mixed effects linear and logistic regression models.

The analysis cohort included 189,448 patients with hypertension. Among the cohort, there was a significant decrease in blood pressure control during the study period: from 77.6% in 2012 to 74.5% in 2016 and 67.7% in 2020 (P<.001 for all comparisons). There was also a decrease in mean total HDD over time: from 1.91 to 1.82 in 2012 and 1.57 in 2020 (P<.001 for both comparisons). With the exception of dihydropyridine calcium channel blockers (increase) and mineralocorticoid receptor antagonists (stable), the use of most medication classes decreased over time.

“Antihypertensive medication intensity decreased in parallel with blood pressure control trends among adults with hypertension in a large US health system, particularly during the COVID-19 pandemic,” the authors said.

Source: Taher M, Brown J, Avula V, Abedi V, Chaudhary D, Chang A, Hypertension medications daily dose usage trend and blood pressure control from 2012-2020 in a large US health system. Poster #375. Abstract of a poster presented at the National Kidney Foundation Spring Clinical Meetings 2023; April 11-15, 2023; Austin, Texas.