ESTIMATING THE PREVALENCE OF UNCONTROLLED AND RESISTANT HYPERTENSION IN THE US: A STEPWISE PATIENT FUNNEL APPROACH USING OPTUM'S MARKET CLARITY DATASET
Author(s)
Alasdair D. Henry, PhD1, Sonia Kim, MS2, Tom Wang, MPH3, Agota Szende, MSc, PhD1, Kay Sadik, PharmD, PhD4, Daniel Malone, BS, RPh, PhD5.
1Genesis Research Group, London, United Kingdom, 2Genesis Research Group, New Jersey, NJ, USA, 3Genesis Research Group, Hoboken, NJ, USA, 4Mineralys Therapeutics, Inc, Charleston, SC, USA, 5University of Utah, Salt Lake City, UT, USA.
1Genesis Research Group, London, United Kingdom, 2Genesis Research Group, New Jersey, NJ, USA, 3Genesis Research Group, Hoboken, NJ, USA, 4Mineralys Therapeutics, Inc, Charleston, SC, USA, 5University of Utah, Salt Lake City, UT, USA.
OBJECTIVES: Hypertension (HTN) is a strong risk factor for cardiovascular disease, stroke, and renal failure. Despite being diagnosed and treated, many patients have uncontrolled HTN, defined as systolic BP ≥130 or diastolic BP >80. The objective of this study was to estimate the real-world prevalence of uncontrolled HTN (uHTN) and resistant HTN (rHTN) in the US.
METHODS: The analysis used Optum’s de-identified Market Clarity Dataset between 2018-2025. The funnel attrition steps began with adult patients (≥18 years) with a HTN diagnosis, 1 inpatient or 2 outpatient visits at least 30 days apart, and at least 1 prescription for an anti-hypertensive treatment (AHT). Among patients diagnosed and treated for HTN and uncontrolled despite being treated, we selected those treated with 2+ AHTs and categorized them by treatment with 2 AHTs and 3+ AHTs. Lastly, the proportion of patients who switched treatment in a year was determined. Demographic and clinical characteristics were reported.
RESULTS: The analysis included 16,473,164 treated patients with HTN. Of these, 53.8% remained uncontrolled despite receiving 2+ AHTs. Among them, 45.1% were treated with 2 AHTs from different classes, and 54.9% had 3+ AHTs. In these cohorts, 11.5% and 11.0%, respectively, switched treatment (added a new AHT class or returned to a prior class). Mean age (SD) among the 2+ AHT population was 64 (12) years; 53% female. The most common comorbidities in patients on 2 AHTs vs 3+ AHTs were hyperlipidemia (56% vs 64%; p<0.001) and type 2 diabetes (28% vs 40%; p<0.001).
CONCLUSIONS: This analysis provides new evidence estimating the prevalence of uHTN and rHTN and describes the small proportion of those who switched to new classes of AHTs. This epidemiological study can inform future economic analyses on the financial impact of introducing new treatments and may help prioritize quality improvement efforts within the context of value-based healthcare in the US.
METHODS: The analysis used Optum’s de-identified Market Clarity Dataset between 2018-2025. The funnel attrition steps began with adult patients (≥18 years) with a HTN diagnosis, 1 inpatient or 2 outpatient visits at least 30 days apart, and at least 1 prescription for an anti-hypertensive treatment (AHT). Among patients diagnosed and treated for HTN and uncontrolled despite being treated, we selected those treated with 2+ AHTs and categorized them by treatment with 2 AHTs and 3+ AHTs. Lastly, the proportion of patients who switched treatment in a year was determined. Demographic and clinical characteristics were reported.
RESULTS: The analysis included 16,473,164 treated patients with HTN. Of these, 53.8% remained uncontrolled despite receiving 2+ AHTs. Among them, 45.1% were treated with 2 AHTs from different classes, and 54.9% had 3+ AHTs. In these cohorts, 11.5% and 11.0%, respectively, switched treatment (added a new AHT class or returned to a prior class). Mean age (SD) among the 2+ AHT population was 64 (12) years; 53% female. The most common comorbidities in patients on 2 AHTs vs 3+ AHTs were hyperlipidemia (56% vs 64%; p<0.001) and type 2 diabetes (28% vs 40%; p<0.001).
CONCLUSIONS: This analysis provides new evidence estimating the prevalence of uHTN and rHTN and describes the small proportion of those who switched to new classes of AHTs. This epidemiological study can inform future economic analyses on the financial impact of introducing new treatments and may help prioritize quality improvement efforts within the context of value-based healthcare in the US.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH1
Topic
Epidemiology & Public Health, Health Service Delivery & Process of Care, Real World Data & Information Systems
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)