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.
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.
复制标题
DOI：
10.1016/j.ahj.2021.10.184
复制
发表时间：
2022-06
影响因子：
4.8
通讯作者：
中科院分区：
文献类型：
--
作者：
在美国，特别是在某些种族/族裔群体中，使用抗高血压药物组合而非单一药物（即单一疗法）治疗高血压的情况并未得到充分利用。尽管整体血压（BP）不受控制，但在种族/族裔群体内识别与单一疗法使用相关的因素可能会阐明治疗不足人群的干预目标。国家健康和营养检查调查的横断面分析（NHANES；2013-2014 年至 2017-2018 年）。我们纳入了年龄 ≥20 岁、患有高血压、至少服用一种抗高血压药物且血压未受控制（收缩压 [SBP] ≥140 mm Hg 或舒张压 [DBP] ≥90 mm Hg）的参与者。使用多变量调整泊松回归确定与抗高血压单一疗法相关的人口统计、临床和医疗保健获取因素。在 1,597 名患有高血压且血压不受控制的参与者中，经年龄和性别调整的单一疗法患病率为 42.6%，非西班牙裔白人为 45.4%，非西班牙裔黑人为 31.9%，西班牙裔为 39.6%，非西班牙裔亚裔成人为 50.9%。总体而言，较高的 SBP 与较高的单一疗法使用率相关，而年龄较大、前一年进行过医疗保健就诊、较高的 BMI 和心力衰竭与较低的单一疗法使用率相关。临床和医疗保健获取因素，包括前一年内的医疗保健就诊和合并症，与联合抗高血压治疗的可能性较高相关。
Treating hypertension with antihypertensive medications combinations, rather than one medication (i.e., monotherapy), is underused in the United States (US), 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. 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 mm Hg or diastolic BP [DBP] ≥90 mm Hg). Demographic, clinical, and healthcare-access factors associated with antihypertensive monotherapy were determined using multivariable-adjusted Poisson regression. 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 BMI, and having heart failure were associated with lower monotherapy use. 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.
登录
查看更多内容
影响因子：
37.8
作者：
Muntner P;Carey RM;Gidding S;Jones DW;Taler SJ;Wright JT Jr;Whelton PK
通讯作者：
Whelton PK
影响因子：
37.8
作者：
Lee, Hokyou;Yano, Yuichiro;Kim, Hyeon Chang
通讯作者：
Kim, Hyeon Chang
影响因子：
5.9
作者：
Wald, David S.;Law, Malcolm;Wald, Nicholas J.
通讯作者：
Wald, Nicholas J.
DOI：
10.1016/j.amjmed.2014.02.026
发表时间：
2014-08
期刊：
The American journal of medicine
影响因子：
--
作者：
Ladabaum U;Mannalithara A;Myer PA;Singh G
通讯作者：
Singh G
影响因子：
0.8
作者：
Yearby, Ruqaiijah
通讯作者：
Yearby, Ruqaiijah