Table 2. Initiation of Antihypertensive Medication With a Renin-Angiotensin-Aldosterone System Inhibitor (ie, ACEI or ARB) Among Those Initiating Antihypertensive Monotherapy and, Separately, Initiating Combination Therapy.
| Variable | Prevalence ratio (95% CI)a,b | |
|---|---|---|
| Beneficiaries initiating monotherapy (n = 31 909) | Beneficiaries initiating combination therapy (n = 9431) | |
| Initiated antihypertensive medication after vs before publication of JNC8 panel member reportc | 1.00 (0.97-1.03) | 1.02 (0.99-1.05) |
| Race/ethnicity | ||
| White | 1 [Reference] | 1 [Reference] |
| Black | 0.68 (0.60-0.77) | 1.02 (0.95-1.09) |
| Other | 0.94 (0.81-1.09) | 1.04 (0.91-1.19) |
| Age, y | ||
| 65-69 | 1 [Reference] | 1 [Reference] |
| 70-74 | 0.97 (0.94-1.01) | 0.97 (0.93-1.00) |
| 75-79 | 0.92 (0.89-0.96) | 0.97 (0.93-1.00) |
| 80-84 | 0.84 (0.80-0.88) | 0.92 (0.88-0.96) |
| ≥85 | 0.67 (0.64-0.71) | 0.88 (0.84-0.92) |
| Male sex | 1.17 (1.13-1.20) | 1.11 (1.08-1.14) |
| Geographical region of residence | ||
| West South Central | 1 [Reference] | 1 [Reference] |
| Mountain | 1.17 (1.10-1.25) | 0.94 (0.88-1.00) |
| East South Central | 0.94 (0.87-1.01) | 0.93 (0.88-0.99) |
| Middle Atlantic | 0.92 (0.87-0.98) | 0.92 (0.88-0.97) |
| South Atlantic | 1.05 (1.00-1.11) | 0.91 (0.88-0.95) |
| West North Central | 1.00 (0.93-1.07) | 0.89 (0.84-0.95) |
| East North Central | 0.97 (0.92-1.03) | 0.92 (0.88-0.96) |
| Pacific | 1.15 (1.09-1.22) | 0.93 (0.89-0.98) |
| New England | 0.94 (0.87-1.01) | 0.89 (0.83-0.96) |
| Cardiologist care | 0.87 (0.83-0.90) | 1.04 (1.00-1.07) |
| Endocrinologist care | 0.92 (0.85-1.00) | 0.93 (0.85-1.02) |
| Nephrologist care | 0.69 (0.56-0.85) | 0.92 (0.76-1.10) |
| Medicare-Medicaid eligible/low income subsidy | 0.88 (0.85-0.91) | 1.02 (0.99-1.06) |
| Area-level median income, $ | ||
| <25 000 | 1 [Reference] | 1 [Reference] |
| 25 000-49 999 | 0.89 (0.76-1.04) | 0.94 (0.85-1.05) |
| 50 000-74 999 | 0.88 (0.76-1.03) | 0.96 (0.87-1.06) |
| ≥75 000 | 0.91 (0.78-1.07) | 0.96 (0.86-1.07) |
Abbreviations: ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; JNC8, Eighth Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.
Prevalence ratios adjusted for antihypertensive medication initiation period, race/ethnicity, antihypertensive medication initiation period × race/ethnicity, age, sex, geographic region of residence, cardiologist care, endocrinologist care, nephrologist care, dual eligibility for Medicare-Medicaid/low income subsidy, and residence area–level median income.
P values for interaction for initiating antihypertensive medication after vs before December 18, 2013: by Black vs White race/ethnicity for monotherapy, P = .60; by other vs White race/ethnicity for monotherapy, P = .35; by Black vs White race/ethnicity for combination therapy, P = .20; by other vs White race/ethnicity for combination therapy, P = .76.
The JNC8 panel member report was published online December 18, 2013.