By Jessica Coacci

U.S. home price growth ticked upwards in April, but affordability pressures still weighed on home buyer decisions.

The S&P Cotality Case-Shiller National Home Price Index, which measures home prices across the country, rose 0.8% in the 12 months through April, compared with a 0.7% increase in March.

For the eleventh consecutive month, U.S. home values fell in real terms, as April's 3.8% inflation ran roughly 3 percentage points above the 0.8% home price gain, the survey said.

"In this higher-rate environment, home price growth remains constrained, with housing largely treading water in nominal terms and falling in real terms," said Nicholas Godec at S&P Dow Jones Indices.

Midwest and Northeast markets are still leading moderate growth, while many Sun Belt and Western metros see ongoing declines. Chicago was again the strongest market with a 6.5% annual gain, followed by New York and Cleveland. Seattle's 2.3% year-over-year drop was the steepest in April.

Cotality continues to have transaction delays from the recording office in Wayne County, the most populous county in the Detroit metro area.

Write to Jessica Coacci at jessica.coacci@wsj.com