Prevalence of hypertension and controlled hypertension - United States, 2005-2008.

National Center for Chronic Disease Prevention and Health Promotion, CDC, USA.
MMWR. Surveillance summaries: Morbidity and mortality weekly report. Surveillance summaries / CDC 01/2011; 60 Suppl:94-7.
Source: PubMed

ABSTRACT Hypertension is a serious public health challenge in the United States, affecting approximately 30% of adults and increasing the risk for heart disease and stroke, the first and third leading causes of death in the United States. Racial/ethnic and socioeconomic disparities in hypertension prevalence in the United States have been documented for decades. Non-Hispanic blacks have a higher risk for hypertension and hypertension-related complications (e.g., stroke, diabetes, and chronic kidney disease) than non-Hispanic whites and Mexican Americans. Between 1999--2000 and 2007--2008, the prevalence of hypertension did not change, but control of hypertension increased among those with hypertension. Despite considerable improvements in increasing awareness, treatment and control of hypertension, in 2007--2008, approximately half of adults with hypertension did not have their blood pressure under control. Because of the fundamental role of hypertension in cardiovascular health, Healthy People 2010 includes national objectives to reduce the proportion of adults aged ≥20 years with hypertension to 14% from a baseline of 26% (objective 12-9) and to increase the proportion of adults aged ≥18 years with hypertension whose blood pressure is under control to 68% from a baseline of 25% (objective 12-10).

  • [Show abstract] [Hide abstract]
    ABSTRACT: Patient age is one of many potential risk factors for fracture nonunion. Our hypothesis is that older patients (≥60) with fracture risk factors treated with low-intensity pulsed ultrasound (LIPUS) have similar heal rate (HR) to the population as a whole. We evaluate the impact of age in conjunction with other risk factors on HR in LIPUS-treated patients with fresh fracture (≤90 days old). The Exogen Bone Healing System is a LIPUS device approved in 1994 to accelerate healing of fresh fracture. After approval, the FDA required a Post-Market Registry to assess performance. Patient data collected from October 1994 until October 1998 were individually reviewed and validated by a registered nurse. Four distinct data elements were required to report a patient: date fracture occurred; date treatment began; date treatment ended; and a dichotomous outcome of healed v. failed, by clinical and radiological criteria. Data were used to calculate two derived variables; days to treatment (DTT) and days on treatment (DOT). Every validated fresh fracture patient with DTT, DOT, and outcome is reported. The validated registry had 5,765 patients with fresh fracture; 73% (N = 4,190) are reported, while 13% of patients were lost to follow-up, 11% withdrew or were non-compliant, and 3% died or are missing outcome. Among treatment-compliant patients, HR was 96.2%. Logistic estimates of the odds ratio for healing are equivalent for patients age 30 to 79 years and all age cohorts had a HR > 94%. Open fracture, current smoking, diabetes, vascular insufficiency, osteoporosis, cancer, rheumatoid arthritis, and prescription NSAIDs all reduced HR, but older patients (≥60) had similar HRs to the population as a whole. DTT was significantly shorter for patients who healed (p < 0.0001). Comorbid conditions in conjunction with aging can reduce fracture HR. Patients with fracture who used LIPUS had a 96% HR, whereas the expected HR averages 93%. Time to treatment was significantly shorter among patients who healed (p < 0.0001), suggesting that it is beneficial to begin LIPUS treatment early. Older patients (≥60) with fracture risk factors treated with LIPUS exhibit similar heal rates to the population as a whole.
    BMC Musculoskeletal Disorders 12/2015; 16(1):498. DOI:10.1186/s12891-015-0498-1 · 1.90 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Secondary data analyses examined the differences in cognitive and instrumental activities of daily living (IADL) performance among hypertensive individuals taking one of four classes of antihypertensive medications, hypertensive individuals not taking any antihypertensive medications, and normotensive individuals (N=770). After adjusting for covariates, significant group differences were evident on all measures (speed of processing, motor speed, reaction time, ps < .05) except memory and Timed IADL (ps > .05). Follow-up a priori planned comparisons compared hypertensive individuals not on medications to each of the four antihypertensive medication groups. Results indicated that only those on beta blockers (BB) were significantly slower in speed of processing (ps < .05). A priori planned comparisons also revealed that normotensive individuals had better cognitive performance on measures of processing speed, motor speed, and reaction time than hypertensive individuals regardless of antihypertensive medication use. Additionally, normotensive individuals performed significantly better on memory (Digit and Spatial Span) than individuals with hypertension on medications. No differences were found between groups on memory (Hopkins Verbal Learning Test) or Timed IADL performance. With regard to antihypertensive medications, the use of BBs was associated with slowed processing speed. These analyses provide empirical evidence that hypertension primarily impacts speed of processing, but not severe enough to affect IADL performance. Given the contribution of processing speed to memory and executive function performance, this is an important finding. Clinicians need to take into consideration the potential negative impact that BBs may have on cognition when determining the best treatment of hypertension among older adult patients.
    Clinical Gerontologist 03/2013; 36(2):113-131. DOI:10.1080/07317115.2012.749322 · 0.66 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: It is well established that unmarried people have higher mortality from circulatory diseases and higher all-cause mortality than the married, and these marital status differences seem to be increasing. However, much remains to be known about the underlying mechanisms. Our objective was to examine marital status differences in the purchase of medication for circulatory diseases, and risk factors for them, which may indicate underuse of such medication by some marital status groups. Using data from registers covering the entire Norwegian population, we analysed marital status differences in the purchase of medicine for eight circulatory disorders by people aged 50-79 in 2004-2008. These differences were compared with those in circulatory disease mortality during 2004-2007, considered as indicating probable differences in disease burden. The unmarried had 1.4-2.8 times higher mortality from the four types of circulatory diseases considered. However, the never-married in particular purchased less medicine for these diseases, or precursor risk factors of these diseases, primarily because of a low chance of making a first purchase. The picture was more mixed for the divorced and widowed. Both groups purchased less of some of these medicines than the married, but, especially in the case of the widowed, relatively more of other types of medicine. In contrast to the never-married, divorced and widowed people were as least as likely as the married to make a first purchase, but adherence rates thereafter, indicated by continuing purchases, were lower. The most plausible interpretation of the findings is that compared with married people, especially the never-married more often have circulatory disorders that are undiagnosed or for which they for other reasons underuse medication. Inadequate use of these potentially very efficient medicines in such a large population group is a serious public health challenge which needs further investigation. It is possible that marital status differences in use of medicines for circulatory disorders combined with an increasing importance of these medicines have contributed to the widening marital status gap in mortality observed in several countries. This also requires further investigation.
    11/2014; 15(1):65. DOI:10.1186/2050-6511-15-65