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Socioeconomic inequalities and trends in self-reported hypertension and antihypertensive medication use in Australia between 2009 and 2021: a nationwide population-based cohort study

Hypertension Research (2025)Cite this article

Abstract

This study examined trends in the proportion of adults with self-reported hypertension and in antihypertensive medication use among community-dwelling Australian adults. We analysed data from a longitudinal panel study, covering four waves: 2009 (n = 8023), 2013 (n = 11,475), 2017 (n = 12,843), and 2021 (n = 14,571) for adults aged 18–74 years. Hypertension and antihypertensive medication use were self-reported. Healthcare subsidy was defined as the possession of a low-income healthcare card, a Pensioner Concession Card, or a Commonwealth Seniors Health Card. Prevalence estimates were age-standardised to the 2016 Australian Census population. The age-standardised prevalence of hypertension remained stable from 2009 to 2021, i.e., 15.7% (95% confidence interval [CI]: 15.1–16.4) in 2009 versus 15.2% (95% CI: 14.6–15.7) in 2021. Antihypertensive medication use increased from 39.4% (95% CI: 37.0–41.7) in 2009 to 46.7% (95% CI: 44.0–49.3) in 2021 (Pfor trend: 0.017). The adjusted prevalence ratios (PR) for hypertension were 1.17 (95% CI: 1.11–1.21) in the 1st (most disadvantaged) Socio-Economic Indexes for Areas (SEIFA) quintiles, compared with the 5th (most advantaged) quintile. The PR for antihypertensive medication use were 1.63 (95% CI: 1.11–1.47) in the 1st quintile compared with the 5th quintile. About 58% to 78% of the increased prevalence of hypertension and antihypertensive medication use related to socioeconomic disadvantage was mediated by healthcare subsidy. The prevalence of hypertension in Australia remained stable between 2009 and 2021. While hypertension drug treatment rates improved over the same period, it remains very low, with less than half of those who reported hypertension receiving antihypertensive medication. Healthcare subsidies improve hypertension detection and treatment, especially in socioeconomically disadvantaged groups.

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Acknowledgements

This paper uses unit record data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Social Services (DSS) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute). The findings and views reported in this paper, however, are those of the author and should not be attributed to either DSS or the Melbourne Institute.

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Authors and Affiliations

  1. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia

    Berhe W. Sahle

  2. Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia

    Dianna J. Magliano

  3. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia

    Dianna J. Magliano, Christopher M. Reid & Mark R. Nelson

  4. School of Medicine, Western Sydney University, Campbelltown, NSW, Australia

    Andre M. N. Renzaho

  5. Faculty of Health Sciences, Curtin University, Bentley, WA, Australia

    Christopher M. Reid

  6. Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia

    Mark R. Nelson

  7. Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia

    Sandra Nolte

  8. School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia

    Sandra Nolte

  9. Cardiovascular, Renal, Metabolism Epidemiology, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK

    Richard Ofori-Asenso

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Correspondence to Berhe W. Sahle.

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RO is an employee of Astrazeneca Plc. The views expressed in this article are his own and do not represent that of his employers. All other authors declare no financial or non-financial competing interests.

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The HILDA Survey was approved by the Faculty of Business and Economics Human Research Ethics Committee at the University of Melbourne (Melbourne, Australia).

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Sahle, B.W., Magliano, D.J., Renzaho, A.M.N. et al. Socioeconomic inequalities and trends in self-reported hypertension and antihypertensive medication use in Australia between 2009 and 2021: a nationwide population-based cohort study. Hypertens Res (2025). https://doi.org/10.1038/s41440-025-02362-1

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