Prevalence of Self-Reported Hypertension and …


Results

During 2017, 2019, and 2021, a total of 444,023, 409,810, and 431,639 participants, respectively, were interviewed. After investigators excluded participants who were pregnant (0.5%–0.6%), missing data for hypertension variables (0.4%–0.5%), and other covariates (3.2%–3.9%), the final analytic samples for 2017, 2019, and 2021 were 425,417 (96% of original sample), 392,100 (96%), and 410,318 (95%), respectively.

Hypertension Prevalence

From 2017 to 2021, the overall age-standardized prevalence of hypertension did not change, remaining at almost exactly 30% (Table 1). In 2021, hypertension prevalence was higher among men (33.2%) than among women (27.0%), among adults aged ≥65 years (60.6%) than among those aged 18–44 years (14.5%) and 45–64 years (40.3%), among Black adults (40.2%) than among Asian adults (22.7%), and among persons with less than a high school education (33.8%) than among those with some college (31.2%) or a college degree or higher education (25.5%).

Although the overall prevalence of hypertension remained unchanged, among persons with less than high school education, hypertension prevalence declined from 36.1% in 2017 to 33.8% in 2021 (p = 0.006). In contrast, a small but statistically significant increase in hypertension prevalence was observed among persons with some college (from 30.2% to 31.2%; p = 0.013) and among persons with college degrees or higher education (from 24.7% to 25.5%; p = 0.004).

By state, the age-standardized prevalence of hypertension ranged from 24.6% in Colorado to 40.6% in Mississippi in 2021. From 2017 to 2021, increases in the prevalence of hypertension were observed in five states (Georgia, Minnesota, Mississippi, Missouri, and Utah) and decreases were observed in three states (Hawaii, Illinois, and New Jersey). Hypertension prevalence was, in general, higher in southeastern and Appalachian states and lower in western states (Figure).

Antihypertensive Medication Use

From 2017 to 2021, age-standardized prevalence of antihypertensive medication use among adults with self-reported hypertension increased by 3.1 percentage points, from 59.8% to 62.9% (p<0.001) (Table 2). In 2021, the prevalence of medication use was higher among women (68.5%) than among men (59.4%), among adults aged ≥65 years (92.5%) than among those aged 18–44 years (42.5%), and among Black (71.3%) than among White adults (62%).

From 2017 to 2021, increases in antihypertensive medication use among persons with hypertension were reported among both men and women, persons aged 18–44 and 45–64 years, White adults, Black adults, and persons at all education levels except among those with less than a high school education, among whom medication use prevalence did not change.

By state, the prevalence of medication use among persons with reported hypertension ranged from 52.2% in Utah to 72.8% in Mississippi in 2021. Antihypertensive medication use increased in 11 states and did not decrease significantly in any state. In general, similar to the prevalence of hypertension, the prevalence of medication use among persons with hypertension was higher in southeastern and Appalachian states and lower in western states (Figure).

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