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News From the Centers for Disease Control and Prevention
June 23/30, 2020

Hypertension Rates in Rural Areas Outpace Those in Urban Locales

JAMA. 2020;323(24):2454. doi:10.1001/jama.2020.9382

Hypertension rates in rural areas are more than 10% higher than in most urban areas, according to a CDC survey.

An analysis of data from the 2017 Behavioral Risk Factor Surveillance System showed that 40% of participants in the most rural areas and 29.4% in the most urban areas reported having a hypertension diagnosis. Prevalence varied widely, from less than 1 in 5 in some counties to more than half the population in others. Most counties in the predominantly rural Southeast and in Appalachia had high hypertension rates, many that topped 50%.

Risk factors for hypertension and heart disease including obesity, cigarette smoking, and physical inactivity are more prevalent in rural areas, the authors noted. These factors, combined with limited access to health care, transportation, and healthful food, create more vulnerable communities in rural areas, they added.

The survey also found that antihypertensive medication use varied widely, from a low rate of 54.3% in some Western counties to a high of 84.7% in certain Great Plains, Southeastern, and Appalachian counties. Antihypertensive use was on the high end in the Dakotas and Nebraska despite having lower rates of hypertension than many Southern counties.

Although men had higher hypertension rates than women, women were more likely to take antihypertensive drugs. The authors noted that more information is needed to understand antihypertensive drug use patterns, such as how many people instead chose lifestyle modifications, and how those patterns vary by region or demographics.

“CDC is working with states to enhance hypertension awareness and management through a strategy of team-based care that involves physicians, nurses, pharmacists, dietitians, and community health workers,” the authors wrote. “The increased use of telemedicine to support this strategy might improve access to care among underserved populations.”