Greater Access To Care And Use Of Antihypertensive Medications Explain Lower Blood Pressures And Better Control In Statin-treated Than Statin-eligible Untreated Adults

Background: Statin-treated adults have much better hypertension (HTN) control than statin-eligible untreated adults, although statins have limited BP effects. This study assessed whether greater access to care and use of BP medications contributed to better HTN control in statin-treated than statin-eligible untreated adults. Methods: NHANES 2009-2020 data were analyzed for adults 21-75 years (N=3,814) with HTN (BP 140+/90+ or treated) and control <140/90. The 2013 ACC/AHA Guideline defined statin eligibility and statin-treated adults deemed eligible. Access to care was defined as having healthcare insurance, at least one healthcare visit in the past year, and usual source of care. Descriptive and multivariate methods were used. Results: During 2009-2020, 69.7% of adults with HTN were statin eligible with 53.0% of statin-eligible adults on statins. Statin-treated vs. statin-eligible untreated adults had lower SBP (130.3 vs. 138.6 mmHg), greater access to care (93.2% vs. 77.7%), and greater HTN awareness, treatment, and better control (Figure, all p-values <0.01). In multivariable analysis, access to care was associated with HTN control (odds ratio,3.03 [95% confidence interval, 2.29-4.02]) and statin therapy (2.52 [1.69-3.78]). The association between statins and HTN control (1.94 [1.53-2.47]) was insignificant after controlling for antihypertensive therapy (1.29 [0.96-1.73]). Conclusions: Better HTN control in statin treated than statin-eligible untreated adults largely reflects greater access to care and use of antihypertensive therapy. Greater access to care in statin-eligible untreated adults may increase both statin therapy and HTN control.