Background: The National Health and Nutrition Examination Survey data indicate that the proportion of US adults with hypertension that had controlled blood pressure (BP) declined from 2013 to 2014 through 2017 to 2018. We analyzed data from National Health and Nutrition Examination Survey 2009 to 2012, 2013 to 2016, and 2017 to 2020 to confirm this finding. Methods: Hypertension was defined as systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg or antihypertensive medication use. BP control among those with hypertension was defined as systolic BP <140 mm Hg and diastolic BP <90 mm Hg. Results: The age-adjusted prevalence of hypertension was 31.5% (95% CI, 30.3%–32.8%), 32.0% (95% CI, 30.6%–33.3%), and 32.9% (95% CI, 31.0%–34.7%) in 2009 to 2012, 2013 to 2016, and 2017 to 2020, respectively ( P trend=0.218). The age-adjusted prevalence of hypertension increased among non-Hispanic Asian adults from 27.0% in 2011 to 2012 to 33.5% in 2017 to 2020 ( P trend=0.003). Among Hispanic adults, the age-adjusted prevalence of hypertension increased from 29.4% in 2009 to 2012 to 33.2% in 2017 to 2020 ( P trend=0.029). In 2009 to 2012, 2013 to 2016, and 2017 to 2020, 52.8% (95% CI, 50.0%–55.7%), 51.3% (95% CI, 47.9%–54.6%), and 48.2% (95% CI, 45.7%–50.8%) of US adults with hypertension had controlled BP ( P trend=0.034). Among US adults taking antihypertensive medication, 69.9% (95% CI, 67.8%–72.0%), 69.3% (95% CI, 66.6%–71.9%), and 67.7% (95% CI, 65.2%–70.3%) had controlled BP in 2009 to 2012, 2013 to 2016, and 2017 to 2020, respectively ( P trend=0.189). Among all US adults with hypertension and those taking antihypertensive medication, a decline in BP control between 2009 to 2012 and 2017 to 2020 occurred among those ≥75 years, women, and non-Hispanic black adults. Conclusions: These data confirm that the proportion of US adults with hypertension who have controlled BP has declined.

Background: Chronic stress experienced at home or work has been associated with acute increases in blood pressure (BP) measured in the doctor’s office, but few data are available on the association of chronic stress with BP measured outside of the office setting. Methods: We analyzed data from 473 African-American adults enrolled in the Jackson Heart Study with office BP < 130/80 mm Hg to examine the association between chronic stress and masked hypertension (MHT). Chronic stress related to jobs, relationships, neighborhoods, caregiving, legal problems, medical problems, racism and discrimination, and meeting basic needs experienced over the previous 12 months was assessed using the 8-item Global Perceived Stress Scale (GPSS). We grouped participants by tertile of the composite GPSS score. Any MHT was defined as awake BP ≥ 130/80 mm Hg, asleep BP ≥ 110/65 mm Hg, or 24-hour BP ≥ 125/75 mm Hg. Analyses were stratified by antihypertensive medication use. Results: Among participants not taking antihypertensive medication (mean age 53 years), the prevalence of any MHT was 59.0%, 75.0% and 61.8% for the low (GPSS score ≤ 3), middle (GPSS score 4 - 6), and upper tertiles of the GPSS score (GPSS score > 6), respectively. Among those taking antihypertensive medication (mean age 61 years), the prevalence of any MHT was 77.4%, 80.7%, and 77.9% for participants in the low, middle, and upper tertile of the GPSS score, respectively. After multivariable adjustment, the prevalence ratio (95% confidence interval) for any MHT associated with the middle and upper versus low tertile of the GPSS score was 1.23 (0.96, 1.57) and 1.07 (0.83, 1.39), respectively, among those not taking antihypertensive medication and 0.97 (0.82, 1.14) and 1.02 (0.85, 1.21), respectively, among those taking antihypertensive medication (Table). Conclusion: No association was present between chronic stress and MHT among African Americans in the Jackson Heart Study.