Trends in Antihypertensive Medication Monotherapy and Combination Use Among US Adults, National Health and Nutrition Examination Survey 2005-2016
Trends in Antihypertensive Medication Monotherapy and Combination Use Among US Adults, National Health and Nutrition Examination Survey 2005-2016
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DOI：
10.1161/hypertensionaha.119.14360
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发表时间：
2020-04-01
期刊：
影响因子：
8.3
通讯作者：
Bress, Adam P.
中科院分区：
文献类型：
--
作者：
Derington, Catherine G.;King, Jordan B.;Bress, Adam P.
在过去的十年里，服用降压药的美国成年人的血压控制率并没有增加。许多成年人需要两种或两种以上的降压药才能达到指南推荐的血压目标，但美国成年人服用单一降压药与联合治疗的比例尚未使用当代数据进行量化。我们分析了2005到2008年、2009到2012年和2013到2016年的全国健康和营养检查调查数据，以确定在年龄=20岁的美国高血压患者中服用降压药的单一疗法和联合用药类别的趋势(n=7837)。在2005年至2008年、2009年至2012年和2013年至2016年，服用降压药但血压不受控制的美国成年人的比例分别为32.3%、30.2%和31.0%(P-趋势=0.37)。在2005-2008年和2013-2016年间，没有证据表明美国成年人服用单一降压药(39.5%-40.4%，P-趋势=0.67)、双重疗法(37.9%-38.3%，P-趋势=0.75)、三联疗法(17.6%-16.5%，P-趋势=0.36)或四联疗法(4.4%-4.3%，P-趋势=0.93)的比例发生变化。在2005-2008年和2013-2016年间，没有证据表明美国成年血压失控的患者服用单一抗高血压药物的比例发生了变化(39.3%-40.6%，P-趋势=0.78)。有很高比例的美国成年人患有高血压，包括那些血压不受控制的人，他们正在服用一种降压药。增加使用双重和三联抗高血压药物方案可能会恢复美国成年人血压控制率的上升趋势。
Blood pressure (BP) control rates among US adults taking antihypertensive medication have not increased over the past decade. Many adults require 2 or more classes of antihypertensive medication to achieve guideline-recommended BP goals, but the proportion of US adults taking antihypertensive medication monotherapy, versus combination therapy, has not been quantified using contemporary data. We analyzed data from 2005 to 2008, 2009 to 2012, and 2013 to 2016 National Health and Nutrition Examination Surveys to determine trends in monotherapy and combinations of antihypertensive medication classes among US adults age >= 20 years with hypertension taking antihypertensive medication (n=7837). The proportion of US adults taking antihypertensive medication with uncontrolled BP (ie, systolic BP >= 140 or diastolic BP >= 90 mm Hg) was 32.3%, 30.2%, and 31.0% in 2005 to 2008, 2009 to 2012, and 2013 to 2016, respectively (P-trend=0.37). Between 2005 to 2008 and 2013 to 2016, there was no evidence of changes in the proportions of US adults taking antihypertensive monotherapy (39.5%-40.4%, P-trend=0.67), dual-therapy (37.9%-38.3%, P-trend=0.75), triple-therapy (17.6%-16.5%, P-trend=0.36), or quadruple-therapy (4.4%-4.3%, P-trend=0.93). Between 2005 to 2008 and 2013 to 2016, there was no evidence of changes in the proportions of US adults with uncontrolled BP taking antihypertensive monotherapy (39.3%-40.6%, P-trend=0.78). A high proportion of US adults with hypertension, including those with uncontrolled BP, are taking one antihypertensive medication class. Increasing the use of dual- and triple-therapy antihypertensive medication regimens may restore the upward trend in BP control rates among US adults.