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Peer-reviewedCC BYCureus

Factors Associated With Uncontrolled Blood Pressure and Its Association With Cardiovascular and All-Cause Mortality Among Adults Receiving Antihypertensive Therapy: A Retrospective Cohort Study Using NHANES 2013-2018 Linked Mortality Data

  • Emmanuel Soyombo1
  • Oluleke A Adeyanju2
  • Christabel A Dike3
  • Chukwuka S Umemba4
  • Chima Iloanugo5
  • Onyedikachi M Amagwu6
  • Chiagozie Ezedinachi7
  • Chiamaka N Ukpabi8
8 affiliations
  1. 1Internal Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, GBR
  2. 2General Practice, Ladoke Akintola University of Technology, Ogbomoso, NGA
  3. 3Internal Medicine, My Medical PC, New York, USA
  4. 4Family Medicine, Medical College of Wisconsin, Milwaukee, USA
  5. 5Internal Medicine, Maidstone and Tunbridge Wells NHS Trust, Maidstone, GBR
  6. 6Psychiatry and Behavioral Sciences, American University of Barbados, St. Michael, BRB
  7. 7Family Medicine, Western University, London, CAN
  8. 8Internal Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, GBR
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Abstract

Background

Uncontrolled blood pressure remains common among adults in the United States receiving antihypertensive therapy. However, contemporary nationally representative evidence examining associated factors and subsequent mortality within the same treated population remains limited.Objective

To identify factors associated with uncontrolled blood pressure and examine its association with all-cause and heart disease mortality.Methods

This retrospective cohort study used National Health and Nutrition Examination Survey (NHANES) 2013-2018 data linked to mortality through 2019. Adults receiving antihypertensive therapy with complete data were included. Uncontrolled blood pressure was defined as mean systolic pressure of at least 130 mmHg or diastolic pressure of at least 80 mmHg. Survey-weighted logistic and Cox regression were performed.Results

The sample included 3,311 adults, representing an estimated 42,895,551 US adults after application of the NHANES examination weights. Uncontrolled blood pressure affected 56.9%. Higher odds were found among other Hispanic adults (adjusted odds ratio (AOR) 1.50, 95% confidence interval (CI), 1.08-2.07), non-Hispanic Black adults (AOR 1.63, 95% CI, 1.29-2.05), and non-Hispanic Asian adults (AOR 1.68, 95% CI, 1.15-2.45). Uncontrolled blood pressure was not significantly associated with all-cause mortality (adjusted hazard ratio (HR) 1.24, 95% CI, 0.87-1.78) or heart disease mortality (adjusted HR 0.97, 95% CI, 0.51-1.84).Conclusion

Uncontrolled blood pressure remained common and differed across population groups. Future studies should use repeated measurements, objective treatment data, and longer follow-up.

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Cite

BibTeXRIS
BibTeX
@article{soyombo2026factors,
  title = {{Factors Associated With Uncontrolled Blood Pressure and Its Association With Cardiovascular and All-Cause Mortality Among Adults Receiving Antihypertensive Therapy: A Retrospective Cohort Study Using NHANES 2013-2018 Linked Mortality Data}},
  author = {Emmanuel Soyombo and Oluleke A Adeyanju and Christabel A Dike and Chukwuka S Umemba and Chima Iloanugo and Onyedikachi M Amagwu and Chiagozie Ezedinachi and Chiamaka N Ukpabi},
  journal = {Cureus},
  year = {2026},
  month = sep,
  doi = {10.7759/cureus.117143},
  url = {https://europepmc.org/article/PMC/PMC13718255},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Factors Associated With Uncontrolled Blood Pressure and Its Association With Cardiovascular and All-Cause Mortality Among Adults Receiving Antihypertensive Therapy: A Retrospective Cohort Study Using NHANES 2013-2018 Linked Mortality Data
AU  - Emmanuel Soyombo
AU  - Oluleke A Adeyanju
AU  - Christabel A Dike
AU  - Chukwuka S Umemba
AU  - Chima Iloanugo
AU  - Onyedikachi M Amagwu
AU  - Chiagozie Ezedinachi
AU  - Chiamaka N Ukpabi
PY  - 2026
DA  - 2026/09/29
JO  - Cureus
DO  - 10.7759/cureus.117143
UR  - https://europepmc.org/article/PMC/PMC13718255
AB  - Background  Uncontrolled blood pressure remains common among adults in the United States receiving antihypertensive therapy. However, contemporary nationally representative evidence examining associated factors and subsequent mortality within the same treated population remains limited.Objective  To identify factors associated with uncontrolled blood pressure and examine its association with all-cause and heart disease mortality.Methods  This retrospective cohort study used National Health and Nutrition Examination Survey (NHANES) 2013-2018 data linked to mortality through 2019. Adults receiving antihypertensive therapy with complete data were included. Uncontrolled blood pressure was defined as mean systolic pressure of at least 130 mmHg or diastolic pressure of at least 80 mmHg. Survey-weighted logistic and Cox regression were performed.Results  The sample included 3,311 adults, representing an estimated 42,895,551 US adults after application of the NHANES examination weights. Uncontrolled blood pressure affected 56.9%. Higher odds were found among other Hispanic adults (adjusted odds ratio (AOR) 1.50, 95% confidence interval (CI), 1.08-2.07), non-Hispanic Black adults (AOR 1.63, 95% CI, 1.29-2.05), and non-Hispanic Asian adults (AOR 1.68, 95% CI, 1.15-2.45). Uncontrolled blood pressure was not significantly associated with all-cause mortality (adjusted hazard ratio (HR) 1.24, 95% CI, 0.87-1.78) or heart disease mortality (adjusted HR 0.97, 95% CI, 0.51-1.84).Conclusion  Uncontrolled blood pressure remained common and differed across population groups. Future studies should use repeated measurements, objective treatment data, and longer follow-up.
SN  - 2168-8184
ER  -