Decline in blood pressure control trends in the US: a real step back: comment on National Health and Nutrition Examination Survey (NHANES) data

This analysis conducted by National Health and Nutrition Examination Survey (NHANES) investigated the changes in blood pressure (BP) control rates between 1999–2000 and 2017–2018, spanning ten 2-year cycles. • The primary outcome of BP control was defined as systolic BP level <140 mm Hg and diastolic BP level <90 mm Hg. The secondary outcomes were hypertension awareness and use of antihypertensive medication. • Among the included 18 262 hypertensive adults (from a total sample of 51 761 individuals), the age-adjusted estimated proportion of adults with controlled BP increased from 1999–2000 through 2007–2008, remained stable from 2007–2008 through 2013–2014, and decreased from 2013–2014 through 2017–2018. BP control rates were higher among older compared to younger participants (50% among those aged 45–64 years vs. 37% among those aged 18–44 years). • BP control, awareness, and antihypertensive medication use were more likely among non-Hispanic white adults, those with health insurance, and those who were undergoing regular follow-up visits. • Temporal trends in age-adjusted proportion of adults with hypertension and controlled BP did not change using the tighter thresholds recommended by 2017 American College of Cardiology/American Heart Association (ACC/AHA) BP guidelines.