Importance Controlling blood pressure (BP) reduces the risk for cardiovascular disease. Objective To determine whether BP control among US adults with hypertension changed from 1999-2000 through 2017-2018. Design, Setting, and Participants Serial cross-sectional analysis of National Health and Nutrition Examination Survey data, weighted to be representative of US adults, between 1999-2000 and 2017-2018 (10 cycles), including 18 262 US adults aged 18 years or older with hypertension defined as systolic BP level of 140 mm Hg or higher, diastolic BP level of 90 mm Hg or higher, or use of antihypertensive medication. The date of final data collection was 2018. Exposures Calendar year. Main Outcomes and Measures Mean BP was computed using 3 measurements. The primary outcome of BP control was defined as systolic BP level lower than 140 mm Hg and diastolic BP level lower than 90 mm Hg. Results Among the 51 761 participants included in this analysis, the mean (SD) age was 48 (19) years and 25 939 (50.1%) were women; 43.2% were non-Hispanic White adults; 21.6%, non-Hispanic Black adults; 5.3%, non-Hispanic Asian adults; and 26.1%, Hispanic adults. Among the 18 262 adults with hypertension, the age-adjusted estimated proportion with controlled BP increased from 31.8% (95% CI, 26.9%-36.7%) in 1999-2000 to 48.5% (95% CI, 45.5%-51.5%) in 2007-2008 (P < .001 for trend), remained stable and was 53.8% (95% CI, 48.7%-59.0%) in 2013-2014 (P = .14 for trend), and then declined to 43.7% (95% CI, 40.2%-47.2%) in 2017-2018 (P = .003 for trend). Compared with adults who were aged 18 years to 44 years, it was estimated that controlled BP was more likely among those aged 45 years to 64 years (49.7% vs 36.7%; multivariable-adjusted prevalence ratio, 1.18 [95% CI, 1.02-1.37]) and less likely among those aged 75 years or older (37.3% vs 36.7%; multivariable-adjusted prevalence ratio, 0.81 [95% CI, 0.65-0.97]). It was estimated that controlled BP was less likely among non-Hispanic Black adults vs non-Hispanic White adults (41.5% vs 48.2%, respectively; multivariable-adjusted prevalence ratio, 0.88; 95% CI, 0.81-0.96). Controlled BP was more likely among those with private insurance (48.2%), Medicare (53.4%), or government health insurance other than Medicare or Medicaid (43.2%) vs among those without health insurance (24.2%) (multivariable-adjusted prevalence ratio, 1.40 [95% CI, 1.08-1.80], 1.47 [95% CI, 1.15-1.89], and 1.36 [95% CI, 1.04-1.76], respectively). Controlled BP was more likely among those with vs those without a usual health care facility (48.4% vs 26.5%, respectively; multivariable-adjusted prevalence ratio, 1.48 [95% CI, 1.13-1.94]) and among those who had vs those who had not had a health care visit in the past year (49.1% vs 8.0%; multivariable-adjusted prevalence ratio, 5.23 [95% CI, 2.88-9.49]). Conclusions and Relevance In a series of cross-sectional surveys weighted to be representative of the adult US population, the prevalence of controlled BP increased between 1999-2000 and 2007-2008, did not significantly change from 2007-2008 through 2013-2014, and then decreased after 2013-2014.

中文翻译：

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1999-2000 年至 2017-2018 年美国成人高血压患者的血压控制趋势

重要性 控制血压 (BP) 可降低患心血管疾病的风险。目的 确定 1999-2000 年至 2017-2018 年期间美国成人高血压患者的血压控制是否发生变化。设计、设置和参与者 对 1999-2000 年和 2017-2018 年（10 个周期）之间的美国成年人进行加权以代表美国成年人的国家健康和营养检查调查数据的连续横断面分析，包括 18262 名 18 岁或老年高血压定义为收缩压水平为 140 毫米汞柱或更高，舒张压水平为 90 毫米汞柱或更高，或使用抗高血压药物。最终数据收集日期为 2018 年。 暴露日历年。主要结果和测量 平均血压是使用 3 次测量计算的。血压控制的主要结果定义为收缩压水平低于 140 毫米汞柱和舒张压水平低于 90 毫米汞柱。结果 在本次分析的 51 761 名参与者中，平均 (SD) 年龄为 48 (19) 岁，女性 25 939 (5​​0.1%)；43.2% 是非西班牙裔白人成年人；21.6%，非西班牙裔黑人成年人；5.3%，非西班牙裔亚裔成年人；26.1%，西班牙裔成年人。在 18 262 名成年高血压患者中，血压控制的年龄调整估计比例从 1999-2000 年的 31.8%（95% CI，26.9%-36.7%）增加到 48.5%（95% CI，45.5%-51.5%） 2007-2008 年（趋势 P < .001）保持稳定，2013-2014 年为 53.8%（95% CI，48.7%-59.0%）（趋势 P = .14），然后下降至 43.7%（ 2017-2018 年的 95% CI，40.2%-47.2%）（趋势 P = .003）。与 18 岁至 44 岁的成年人相比，据估计，血压控制在 45 岁至 64 岁人群中的可能性更大（49.7% 对 36.7%；多变量调整的患病率比，1.18 [95% CI，1.02-1.37]），而在 75 岁或年龄较大（37.3% 对 36.7%；多变量调整的患病率比，0.81 [95% CI，0.65-0.97]）。据估计，非西班牙裔黑人成人与非西班牙裔白人成人相比，控制血压的可能性较小（分别为 41.5% 和 48.2%；多变量调整的患病率比，0.88；95% CI，0.81-0.96）。有私人保险 (48.2%)、Medicare (53.4%) 或除 Medicare 或 Medicaid 以外的政府医疗保险 (43.2%) 的人比没有医疗保险的人 (24.2%) 更有可能控制血压（多变量调整患病率, 1.40 [95% CI, 1.08-1.80], 1.47 [95% CI, 1.15-1.89], 和 1.36 [95% CI, 1.04-1.76], 分别）。有常规医疗机构的患者与没有常规医疗机构的患者相比，血压得到控制的可能性更高（分别为 48.4% 和 26.5%；多变量调整的患病率比，1.48 [95% CI，1.13-1.94]）以及有常规医疗机构的患者与没有常规医疗机构的患者过去一年没有就诊（49.1% 对 8.0%；多变量调整的患病率比，5.23 [95% CI，2.88-9.49]）。结论和相关性 在一系列加权代表美国成年人口的横断面调查中，控制血压的患病率在 1999-2000 年和 2007-2008 年之间增加，从 2007-2008 年到 2013-2014 年没有显着变化，并且然后在 2013-2014 年之后下降。48 [95% CI, 1.13-1.94]) 以及在过去一年中曾就诊与未就诊的患者之间（49.1% 对 8.0%；多变量调整的患病率比，5.23 [95% CI，2.88] -9.49]）。结论和相关性 在一系列加权代表美国成年人口的横断面调查中，控制血压的患病率在 1999-2000 年和 2007-2008 年之间增加，从 2007-2008 年到 2013-2014 年没有显着变化，并且然后在 2013-2014 年之后下降。48 [95% CI, 1.13-1.94]) 以及在过去一年中曾就诊与未就诊的患者之间（49.1% 对 8.0%；多变量调整的患病率比，5.23 [95% CI，2.88] -9.49]）。结论和相关性 在一系列加权代表美国成年人口的横断面调查中，控制血压的患病率在 1999-2000 年和 2007-2008 年之间增加，从 2007-2008 年到 2013-2014 年没有显着变化，并且然后在 2013-2014 年之后下降。