In a study from Augusta University, scientists found people who live in large urban areas may be less likely to take prescribed medications for high blood pressure and less likely to have a primary care provider than those living in smaller rural communities.
The findings also suggest there are regional differences, with those living in the western part of the U.S. least likely to take medication prescribed for high blood pressure.
Nearly half of all U.S. adults have high blood pressure, also called hypertension.
It often has no obvious symptoms, but left untreated it can damage the cardiovascular system, contributing to the risk of a heart attack, stroke, and other chronic health conditions.
Previous research found that if just 25% of Medicare patients who didn’t take their blood pressure medication started doing so, the U.S. would save $13.7 billion annually and avoid more than 100,000 emergency department visits.
In the study, the team analyzed data from more than 11,000 people in the 2020 National Health Interview Survey, conducted by the Centers for Disease Control and Prevention.
Those people were a representative sample of more than 71 million people across the U.S. diagnosed with high blood pressure.
The researchers found that nearly 76% of people in large urban populations took the blood pressure medications prescribed to them, with adherence growing as population density decreased.
In large fringe urban areas and medium urban areas, nearly 82% of people took their blood pressure medication. In smaller non-metro areas, 83% of people were adherent.
Researchers found regional differences as well. People living in the Northeast were most likely to take the medications prescribed to them, with about 83% being adherent.
In the South, more than 81% of people took their medications, and 79% of people in the Midwest did so. The West had the lowest rate of medication adherence, at about 77%.
The data showed a link between medication adherence and access to primary care, suggesting those who had less access to health care were more likely to stop taking their prescribed medications.
The team expected to see less access to physicians in rural areas than in urban ones, but that was not the case.
About 14% of the U.S. population lives in a rural areas, but only one-tenth of primary care physicians practice there.
Yet 97% of rural residents in this study reported having access to regular care if they needed it, compared to less than 95% of people in large urban areas.
The team said access to care also can be affected by income, a variable the researchers didn’t factor in. Another issue could be that people in cities tend to move more than those who live in rural areas and might have less continuity of care.
If you care about high blood pressure, please read studies about which blood pressure number matters most, and this blood pressure drug may increase the risk of sudden cardiac arrest.
For more information about blood pressure, please see recent studies that blood pressure swings could be an early sign of heart disease, and results showing beetroot may protect against high blood pressure.
The study was conducted by Samantha Schoenl et al and presented at the American Heart Association’s Hypertension Scientific Sessions.
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