Trends in the Prevalence, Awareness, Treatment, and Control of Hypertension in the Adult US Population

Abstract

The objective of this study was to describe secular trends in the distribution of blood pressure and prevalence of hypertension in US adults and changes in rates of awareness, treatment, and control of hypertension. The study design comprised nationally representative cross-sectional surveys with both an in-person interview and a medical examination that included blood pressure measurement. Between 6530 and 13,645 adults, aged 18 through 74 years, were examined in each of four separate national surveys during 1960-1962, 1971-1974, 1976-1980, and 1988-1991. Protocols for blood pressure measurement varied significantly across the surveys and are presented in detail. Between the first (1971-1974) and second (1976-1980) National Health and Nutrition Examination Surveys (NHANES I and NHANES II, respectively), age-adjusted prevalence of hypertension at > or = 160/95 mm Hg remained stable at approximately 20%. In NHANES III (1988-1991), it was 14.2%. Age-adjusted prevalence at > or = 140/90 mm Hg peaked at 36.3% in NHANES I and declined to 20.4% in NHANES III. Age-specific prevalence rates have decreased for every age-sex-race subgroup except for black men aged 50 and older. Age-adjusted mean systolic pressures declined progressively from 131 mm Hg at the NHANES I examination to 119 mm Hg at the NHANES III examination. The mean systolic and diastolic pressures of every sex-race subgroup declined between NHANES II and III (3 to 6 mm Hg systolic, 6 to 9 mm Hg diastolic). During the interval between NHANES II and III, the threshold for defining hypertension was changed from 160/95 to 140/90 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevalence, awareness, treatment, and control of hypertension in the Czech Republic. Results of two nationwide cross-sectional surveys in 1997/1998 and 2000/2001, Czech Post-MONICA Study

“…27 However, there is no doubt that the fact that one-third of the population is not aware of hypertension and, consequently, not treated, contributes to the unsatisfactory overall control of hypertension. In a review by Marques-Vidal and Tuomilehto, 28 24 population surveys of hypertension awareness, treatment, and control published since 1983 were assessed.…”

Hypertension in black South Africans

“…Thus even in the USA, black people have a far higher prevalence of hypertension compared to the Caucasian population. 4 The prevalence of hypertension in black people in the West Indies and in the USA is higher than those in any part of sub-Saharan Africa. This may be because African Americans having been accultured for 300 years, whereas urban Zulus have been accultured only since the turn of the 20th century.…”

Trends in the prevalence of isolated systolic hypertension in the middle-aged population in 1972–1992

“…In the NHANES I in 1971-1974 and two subsequent cross-sectional cohorts in the US population in 1976-1980 and 1988-1991 the prevalences were 20%, 21% and 14%, respectively, among white men and 18%, 17% and 13%, respectively, among white women aged 18-74 years. 27 In three Swedish surveys using consistent methods the prevalence of DHT and ISH combined among men aged 50 years was 37% in 1973, 14% in 1983 and 17% in 1993. 28 In two different Belgian populationbased studies, the age-standardised prevalence among men aged 25-64 years was 20% in 1980-1984 and 13% in 1985-1992 (P Ͻ 0.001) and the values among women were 19% and 13% (P Ͻ 0.001), respectively.…”