Abstract 16875: Trends in Uncontrolled Hypertension, Coronary Heart Disease and Stroke Mortality, and Million Heart Events Among Us Adults From 1999-2014: Difference Between Age Groups
Introduction: Hypertension (HTN) is the leading risk factor for cardiovascular disease (CVD). Control of HTN can effectively reduce fatal and non-fatal CVD events. The age disparity in trends of HTN control and the corresponding CVD events are not well explored.
Hypothesis: Temporal trends in the prevalence of uncontrolled HTN, coronary heart disease (CHD) and stroke mortality, and Million Hearts (MH) events are consistent across three adult age groups.
Methods: Among adults (≥18 years), we calculated the prevalence of uncontrolled HTN (blood pressure ≥140/90 mmHg) using data from the National Health and Nutrition Examination Survey 1999-2014. CHD and stroke mortality rates were defined by ICD codes I20-I25 and I60-69, respectively. MH event rates were calculated using combined data from the National Vital Statistics System mortality data and the Healthcare Cost and Utilization Project’s National Impatient Sample and Nationwide Emergency Department Sample surveys. Overall age-standardized rates and age-specific rates are provided.
Results: Among all adults, the prevalence of uncontrolled HTN (%), CHD and stroke mortality (per 100,000), and MH events (per 100,000) decreased from 19.8%, 255.9, 81.8, and 1265.1 in 1999-2000 to 13.7%, 138.1, 49.2, and 1072.7 in 2013-14, respectively. This translates into average (two-year) cycle decreases of -5.0%, -8.4%, -7.0%, and -4.0%, respectively. Compared to the youngest age group (18-44 years), the ratio of decrease in prevalence of uncontrolled HTN was 1.0 and 2.3 for the 45-64 and 65+ age groups, respectively. The corresponding ratio was 0.9 and 1.7 for CHD mortality, 0.6 and 1.5 for stroke mortality, and 0.5 and 1.9 for MH events, respectively.
Conclusions: From 1999 to 2014, considerable improvement occurred in HTN control as well as fatal and nonfatal CVD event rates. The improvement in HTN control was less pronounced among younger adults (aged <65 years) and was accompanied by a slower decline in CHD and stroke mortality and MH event rates compared to older adults (aged ≥65 years). Better HTN control among younger adults would promote a greater decline in CVD events and mortality.
Author Disclosures: Y. Hong: None. C. Gillespie: None. M. Ritchey: None. L. Fine: None. B. Bowman: None.
- © 2016 by American Heart Association, Inc.