ArticleJournal of the American College of Cardiology2025
Trends in Prevalence, Treatment, and Control of Cardiometabolic Risk Factors Among Adults With Hypertension in the United States, 1999-2023.
Article in Journal of the American College of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and safety of intensive vs. standard blood pressure control: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2026Pooled it
- Recognition and control gaps in advanced cardiovascular-kidney-metabolic syndrome among United States adults.Preventive medicine reports · 2026Article
- Failing on Both Sides of the Infarct: Lipid-Lowering Therapy and the Delivery Gap.JACC. Advances · 2026Article
- Association Between mHealth Literacy and Hypertension-Related KAP Among Older Adults with Hypertension: Chain-Mediating Roles of Health Empowerment and Patient Activation.Healthcare (Basel, Switzerland) · 2026Article
- Cardiovascular Risk Awareness Among Adults in the Northern Border Region of Saudi Arabia: A Cross-Sectional Study with Emphasis on Hypertension and Type 2 Diabetes.Diseases (Basel, Switzerland) · 2026Article
- Mortality trends and disparities associated with aortic aneurysm and aortic dissection in the United States from 1999 to 2023: a CDC WONDER database analysis.BMC cardiovascular disorders · 2026Article
- Quantifying population-level antihypertensive treatment eligibility under the 2025 AHA/ACC hypertension guideline: What has changed - And where the greatest opportunity remains.American journal of preventive cardiology · 2026Article
- Comparative efficacy and safety of dual-combination vs. triple-combination antihypertensive therapies in hypertensive patients: an updated meta-analysis of randomized controlled trials.Frontiers in pharmacology · 2026Review
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Abstract
backgroundHypertension-related deaths in the United States have sharply increased over the past decade. Understanding factors behind this concerning trend is crucial to guide public health strategies.
objectivesThis study sought to examine changes in prevalence, treatment, and control of cardiometabolic risk factors among U.S. adults with hypertension.
methodsUsing National Health and Nutrition Examination Survey, we identified 21,822 adults with hypertension from 1999 to 2023. Trends in age-adjusted prevalence of diabetes, hyperlipidemia, obesity, smoking, and high-risk drinking, as well as in age-adjusted treatment and control rates for hypertension, diabetes, and hyperlipidemia, were assessed.
resultsIn adults with hypertension, prevalence of diabetes increased from 17.2% (95% CI: 14.6%-20.2%) in 1999-2000 to 27.8% (95% CI: 25.2%-30.7%) in 2021-2023. Among patients with hypertension and diabetes, the proportion receiving treatment for both conditions rose until 2009-2010 but subsequently plateaued (71.6% in 2021-2023; 95% CI: 67.5%-75.4%). A similar trend was observed for the proportion achieving control of both conditions, which remained at 31.2% in 2021-2023 (95% CI: 26.5%-36.3%). Prevalence of hyperlipidemia decreased in adults with hypertension but was still high at 73.1% (95% CI: 70.6%-75.4%) in 2021-2023. Among patients with hypertension and hyperlipidemia, treatment and control rates for both conditions increased only until around 2007; the respective rates were 50.4% (95% CI: 47.2%-53.6%) and 32.3% (95% CI: 29.5%-35.2%) in 2021-2023. Prevalence of concurrent diabetes and hyperlipidemia in adults with hypertension nearly doubled from 12.5% (95% CI: 10.6%-14.7%) in 1999-2000 to 21.3% (95% CI: 19.0%-23.8%) in 2021-2023. Among patients with hypertension, diabetes, and hyperlipidemia, the treatment rate for all 3 conditions increased until 2007-2008 and plateaued afterward (62.1% in 2021-2023; 95% CI: 56.6%-67.2%). The control rate for all 3 conditions followed a similar trend but remained low at 26.3% (95% CI: 20.8%-32.6%) in 2021-2023. Prevalence of obesity and high-risk drinking increased over time, whereas prevalence of smoking held steady.
conclusionsThe burden of cardiometabolic risk factors among U.S. adults with hypertension has increased overall, with concurrent diabetes and hyperlipidemia now affecting more than 1 in 5. Only one-quarter of adults with hypertension, diabetes, and hyperlipidemia have all 3 conditions controlled-a proportion that has not improved in more than a decade.
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