Diverse trends in antihypertensive medication usage among US Adults with hypertension by socioeconomic status and comorbidities, 1999-2020

Background: Hypertension is a global health concern, and antihypertensive medications are vital for its management. This study examined evolving trends in antihypertensive medication usage among adults with hypertension from 1999 to 2020. Methods: Data from 10 National Health and Nutrition Examination Survey (NHANES) survey cycles were obtained for adults aged 18 years and older with hypertension. The study analysed demographic, drug classification and demographic variables. All statistical analyses, including logistic regression, were used to assess trends. Results: Among 18,221 hypertensive participants, diverse characteristics were observed. The use of angiotensin-converting enzyme inhibitors increased from 26.18% in 1999 to 32.76% in 2020 (linear p = 0.001). Angiotensin receptor blocker use rose from 10.36% to 26.57%. Beta blocker usage increased from 28.98% in 1999 to 42.50% in 2010, plateauing at approximately 40% from 2011 to 2020 (quadratic p < 0.001). Calcium channel blocker (CCB) utilisation increased from 16.70% in 1999 to 20.46% in 2020 (linear p < 0.001). Diuretic (DU) use decreased from 32.70% in 1999 to 26.34% in 2020 (quadratic p = 0.009). The use of antihypertensive medications varies across different demographic groups and comorbidities. Conclusions: ACEI, ARB and CCB usage increased, while DU usage decreased. BB utilisation stabilised at a high rate. Antihypertensive drug use displayed diverse trends across demographic groups and comorbidities.