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Differences in hypertension prevalence and hypertension control by urbanization among adults in the United States, 2013-2018

Am J Hypertens. 2021 Apr 28:hpab067. doi: 10.1093/ajh/hpab067. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the associations between urbanization and hypertension, stage II hypertension, and hypertension control.

METHODS: Data on 16,360 U.S. adults aged 18 years or older from the 2013-2018 National Health and Nutrition Examination Survey (NHANES) were used to estimate the prevalence of hypertension (blood pressure (BP) ≥130/80 mm Hg or use of medication for hypertension), stage II hypertension (BP ≥140/90 mm Hg), and hypertension control (BP < 130/80 mm Hg among hypertensives) by urbanization, classified by levels of metropolitan statistical areas as large MSAs (population ≥ 1,000,000), medium to small MSAs (population 50,000-999,999), and non-MSAs (population <50,000)).

RESULTS: All prevalence ratios (PRs) were compared with large MSAs and adjusted for demographics and risk factors. The PRs of hypertension were 1.07 (95% CI= 0.99-1.14) for adults residing in medium to small MSAs and 1.06 (95% CI=0.99- 1.13) for adults residing in non-MSAs, For stage II hypertension, the PRs were higher for adults residing in medium to small MSAs 1.21 (95% CI =1.06-1.36) but not for adults residing in non-MSAs 1.06 (95% CI= 0.88-1.29). For hypertension control, the PRs were 0.96 (95% CI=0.91-1.01) for adults residing in medium to small MSAs and 1.00 (95% CI=0.93-1.06) for adults residing in non-MSAs.

CONCLUSION: Among U.S. adults, urbanization was associated with stage II hypertension.

PMID:33909014 | DOI:10.1093/ajh/hpab067

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