BMI and blood pressure control among United States adults with hypertension

Area of Science:

• Cardiovascular Health
• Public Health
• Obesity Research

Background:

• Hypertension affects over half of US adults, with suboptimal blood pressure (BP) control.
• Higher Body Mass Index (BMI) is a known risk factor for hypertension.
• The relationship between BMI and BP control in hypertensive individuals requires further elucidation.

Purpose of the Study:

• To investigate the association between BMI categories and hypertension awareness.
• To examine the relationship between BMI and antihypertensive medication use.
• To assess BP control rates across different BMI categories in US adults with hypertension.

Main Methods:

• Analysis of data from 3568 US adults with hypertension (2015-2018 NHANES).
• BMI categorized into normal (<25 kg/m²), overweight (25–<30 kg/m²), class 1 obesity (30–<35 kg/m²), and class 2/3 obesity (≥35 kg/m²).
• Hypertension awareness, medication use, and BP control (<140/90 mmHg) were evaluated by BMI category.

Main Results:

• Prevalence of normal BMI, overweight, class 1 obesity, and class 2/3 obesity among hypertensive adults was 15.6%, 31.3%, 26.2%, and 26.8%, respectively.
• Hypertension awareness increased with BMI: 67.9% (normal BMI) to 87.8% (class 2/3 obesity).
• BP control rates among those on medication were 63.5% (normal BMI) to 71.1% (class 1 obesity), with overall controlled BP rates of 37.1% (normal BMI) to 53.8% (class 1 obesity).

Conclusions:

• US adults with hypertension and normal BMI demonstrated lower hypertension awareness and BP control compared to those with overweight or obesity.
• Higher BMI categories were associated with increased hypertension awareness and, for class 1 obesity, higher BP control rates.
• Findings highlight disparities in hypertension management across BMI spectrums, suggesting targeted interventions may be needed for normal BMI individuals.