Healthy People 2020 is a national initiative that was launched in 2010 and outlines 10-year goals and objectives for health promotion and disease prevention. Reducing the burden of cardiovascular disease is part of the initiative, and Healthy People 2020 established the following goals for adults in the United States regarding blood pressure (BP) control.
♦ Decrease the prevalence of hypertension to 26.9%.
♦ Increase the percentage of hypertensive patients on BP medication to 69.5%.
♦ Increase hypertension control to 61.2% (this requires controlling hypertension in 88.1% of those on BP treatment).
A Status Update
A study published in Circulation assessed the current status and progress toward the Healthy People 2020 goals. For the analysis, Brent M. Egan, MD, and colleagues used the National Health and Nutrition Examination Surveys from more than 37,000 adults between 1999 and 2012 and looked at time trends data in 2-year blocks.
“The prevalence of hypertension changed very little over this period,” says Dr. Egan. “However, hypertension treatment and the proportion of treated adults who got their BP under control increased significantly.” Hypertension control—defined as reaching a BP of less than 140/90 mm Hg—increased every 2 years from 1999-2000 to 2009-2010 before leveling off slightly to just over 51% in 2011-2012.
Identifying Strong Predictors
Several modifiable risk factors were found to be strong predictors of BP control. Patients who visited their healthcare provider at least twice a year were 3.2 times more likely to keep their BP under control than those who saw their providers less frequently. Patients who had healthcare insurance and received treatment for high cholesterol also had a greater likelihood of keeping their BP under control.
Dr. Egan adds that individuals who had more visits were more likely to be aware of their hypertension than those who had fewer than two healthcare visits annually. They were also more likely to be treated when they were aware, and more likely to have their BP controlled when treated. These factors contributed equally to the difference in hypertension control between adults with fewer than two annual visits and those with two or more yearly healthcare visits.
Egan BM, Li J, Hutchison FN, Ferdinand KC. Hypertension in the United States 1999-2012: progress toward Healthy People 2020 goals. Circulation. 2014 Oct 20 [Epub ahead of print]. Available at: http://circ.ahajournals.org/content/early/2014/09/24/CIRCULATIONAHA.114.010676.abstract.
Centers for Disease Control and Prevention (CDC). Vital signs: prevalence, treatment, and control of hypertension–United States, 1999-2002 and 2005-2008. MMWR Morb Mortal Wkly Rep. 2011;60:103-108.
Egan BM, Li J, Qanungo S, Wolfman TE. Blood pressure and cholesterol control in hypertensive hypercholesterolemic patients: national health and nutrition examination surveys 1988-2010. Circulation. 2013;128:29-41.
Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA. 2010;303:2043-2050.