Abstract
Abstract:The objective of this study was to compare rates of use of medications for diabetes, hypertension, and hypercholesterolemia between 1988–1994 and 2001–2006 and determine whether increased medication use may be partly attributable to nonadherence to healthy lifestyle habits. This study analyzed and compared data from two different time periods in the National Health and Nutrition Examination Survey (NHANES). Disease prevalence rates increased 23% (P < 0.01), and medication use increased 121% (P < 0.05) over the study’s period. Diabetes medication use increased from 5.3% to 8.7%, antihypertension medication from 23.0% to 32.4%, and cholesterol-lowering medication from 4.5% to 16.7% (all P < 0.05). By race, diabetes medication use increased most among Hispanics (7.2% to 13.2%), antihypertension use increased most among non-Hispanic blacks (30.8% and 39.6%), and cholesterol medication increased most in non-Hispanic whites (4.9% to 17.8%) (all P < 0.05). Greater adherence to healthy lifestyle habits was associated with less use of medication (P < 0.01). Medication use for diabetes, hypertension, and hypercholesterolemia has increased between 1988–1994 and 2001–2006 and is greater in people with fewer healthy lifestyle habits.
This content is limited to qualifying members.
If you have an existing account please login now to access this article or view purchase options.
Create a free account, then purchase this article to download or access it online for 24 hours.
Create a free account, then purchase a subscription to get complete access to all articles for a full year.
References
References1. Hajjar I, Kotchen T. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA 2003;290:199–206.HajjarI]]KotchenTTrends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000.JAMA2003290199-2062. Carroll M, Lacher D, Sorlie P, et al. Trends in serum lipids and lipoproteins in adults, 1960-2002. JAMA 2005;294:1773–1781.CarrollM]]LacherD]]SorlieP&etal;Trends in serum lipids and lipoproteins in adults, 1960-2002.JAMA20052941773-17813. Kilmer G, Roberts H, Hughes E, et al. Surveillance of certain health behaviors and conditions among states and selected local areas—Behavioral Risk Factor Surveillance System (BRFSS), United States, 2006. MMWR Surveill Summ 2008;57:1–188.KilmerG]]RobertsH]]HughesE&etal;Surveillance of certain health behaviors and conditions among states and selected local areas—Behavioral Risk Factor Surveillance System (BRFSS), United States, 2006.MMWR Surveill Summ2008571-1884. Ong K, Cheung B, Man Y, et al. Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004. Hypertension 2007;49:69–75.OngK]]CheungB]]ManY&etal;Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004.Hypertension20074969-755. Ford ES, Mokdad AH, Giles WH, et al. Serum total cholesterol concentrations and awareness, treatment, and control of hypercholesterolemia among U.S. adults: findings from the National Health and Nutrition Examination Survey, 1999 to 2000. Circulation 2003;107:2185–2189.FordES]]MokdadAH]]GilesWH&etal;Serum total cholesterol concentrations and awareness, treatment, and control of hypercholesterolemia among U.S. adults: findings from the National Health and Nutrition Examination Survey, 1999 to 2000.Circulation20031072185-21896. Geiss LS, Herman WH, Goldschmid MG, et al. Surveillance for diabetes mellitus—United States, 1980-1989. MMWR CDC Surveill Summ 1993;42:1–20.GeissLS]]HermanWH]]GoldschmidMG&etal;Surveillance for diabetes mellitus—United States, 1980-1989.MMWR CDC Surveill Summ1993421-207. Reeves M, Rafferty A. Healthy lifestyle characteristics among adults in the United States, 2000. Arch Intern Med 2005;165:854–857.ReevesM]]RaffertyAHealthy lifestyle characteristics among adults in the United States, 2000.Arch Intern Med2005165854-8578. Franz MJ, Boucher JL, Green-Pastors J, et al. Evidence-based nutrition practice guidelines for diabetes and scope and standards of practice. J Am Diet Assoc 2008;108(4 suppl 1):S52–S58.FranzMJ]]BoucherJL]]Green-PastorsJ&etal;Evidence-based nutrition practice guidelines for diabetes and scope and standards of practice.J Am Diet Assoc2008108S52-S589. Alexander GC, Sehgal NL, Moloney RM, et al. National trends in treatment of type 2 diabetes mellitus, 1994-2007. Arch Intern Med 2008;168:2088–2094.AlexanderGC]]SehgalNL]]MoloneyRM&etal;National trends in treatment of type 2 diabetes mellitus, 1994-2007.Arch Intern Med20081682088-209410. NCHS 1994. Plan and operation of the Third National Health and Nutrition Survey, 1988-1994. Hyattsville, Maryland, National Center for Health Statistics. Vital health Stat 1994;1:1–416.NCHS 1994Plan and operation of the Third National Health and Nutrition Survey, 1988-1994. Hyattsville, Maryland, National Center for Health Statistics.Vital health Stat199411-41611. United States Department of Agriculture. Dietary Guidelines for Americans—2005. Available at: http://www.health.gov/DIETARYGUIDELINES/dga2005/document/html/chapter9.htm. Accessed April 23, 2009.12. King DE, Mainous AG III, Carnemolla M, et al. Adherence to healthy lifestyles habits in US adults, 1988-2006. Am J Med 2009;122:528–534.KingDE]]MainousAGIII]]CarnemollaM&etal;Adherence to healthy lifestyles habits in US adults, 1988-2006.Am J Med2009122528-53413. Walmart. $4 Prescriptions Program. Available at: http://www.walmart.com/catalog/catalog.gsp?cat=546834. Accessed April 23, 2009.14. Hsu WC. Consequences of delaying progression to optimal therapy in patients with type 2 diabetes not achieving glycemic goals. South Med J 2009;102:67–76.HsuWCConsequences of delaying progression to optimal therapy in patients with type 2 diabetes not achieving glycemic goals.South Med J200910267-7615. Cushman WC, Basile J. Achieving blood pressure goals: why aren’t we? J Clin Hypertens (Greenwich) 2006;8:865–872.CushmanWC]]BasileJAchieving blood pressure goals: why aren’t we?J Clin Hypertens (Greenwich)20068865-87216. Ali YS, Linton MF, Fazio S. Targeting cardiovascular risk in patients with diabetes: management of dylipidemia. Curr Opin Endocrinol Diabetes Obes 2008;2:142–146.AliYS]]LintonMF]]FazioSTargeting cardiovascular risk in patients with diabetes: management of dylipidemia.Curr Opin Endocrinol Diabetes Obes20082142-14617. Booth GL, Kapral MK, Fung K, et al. Recent trends in cardiovascular complications among men and women with and without diabetes. Diabetes Care 2006;29:32–37.BoothGL]]KapralMK]]FungK&etal;Recent trends in cardiovascular complications among men and women with and without diabetes.Diabetes Care20062932-3718. Steyer TE, King DE, Mainous AG III, et al. Use of nutritional supplements for the prevention and treatment of hypercholesterolemia. Nutrition 2003;19:415–418.SteyerTE]]KingDE]]MainousAGIII&etal;Use of nutritional supplements for the prevention and treatment of hypercholesterolemia.Nutrition200319415-41819. Chiuve S, McCullough M, Sacks F, et al. Healthy lifestyle factors in the primary prevention of coronary heart disease among men: benefits among users and nonusers of lipid-lowering and antihypertensive medications. Circulation 2006;114:160–167.ChiuveS]]McCulloughM]]SacksF&etal;Healthy lifestyle factors in the primary prevention of coronary heart disease among men: benefits among users and nonusers of lipid-lowering and antihypertensive medications.Circulation2006114160-16720. Bushardt RL, Massey EB, Simpson TW, et al. Polypharmacy: misleading, but manageable. Clin Interv Aging 2008;3:383–389.BushardtRL]]MasseyEB]]SimpsonTW&etal;Polypharmacy: misleading, but manageable.Clin Interv Aging20083383-38921. Roth M, Ivey J. Self-reported medication use in community-residing older adults: a pilot study. Am J Geriatr Pharmacother 2005;3:196–204.RothM]]IveyJSelf-reported medication use in community-residing older adults: a pilot study.Am J Geriatr Pharmacother20053196-20422. Ballentine NH. Polypharmacy in the elderly: maximizing benefit, minimizing harm. Crit Care Nurs Q 2008;31:40–45.BallentineNHPolypharmacy in the elderly: maximizing benefit, minimizing harm.Crit Care Nurs Q20083140-4523. Fick DM, Mion LC, Beers MH, et al. Health outcomes associated with potentially inappropriate medication use in older adults. Res Nurs Health 2008;31:42–51.FickDM]]MionLC]]BeersMH&etal;Health outcomes associated with potentially inappropriate medication use in older adults.Res Nurs Health20083142-5124. van der Hooft CS, Dieleman JP, et al. Adverse drug reaction-related hospitalisations: a population-based cohort study. Pharmacoepidemiol Drug Saf 2008;17:365–371.van der HooftCS]]DielemanJP&etal;Adverse drug reaction-related hospitalisations: a population-based cohort study.Pharmacoepidemiol Drug Saf200817365-37125. Zed PJ, Abu-Laban RB, Balen RM, et al. Incidence, severity and preventability of medication-related visits to the emergency department: a prospective study. CMAJ 2008;178:1563–1569.ZedPJ]]Abu-LabanRB]]BalenRM&etal;Incidence, severity and preventability of medication-related visits to the emergency department: a prospective study.CMAJ20081781563-1569
