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Hypertension. 2008;52:818-827
Published online before print October 13, 2008, doi: 10.1161/HYPERTENSIONAHA.108.113357
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(Hypertension. 2008;52:818.)
© 2008 American Heart Association, Inc.


Original Articles

Trends in Hypertension Prevalence, Awareness, Treatment, and Control Rates in United States Adults Between 1988–1994 and 1999–2004

Jeffrey A. Cutler; Paul D. Sorlie; Michael Wolz; Thomas Thom; Larry E. Fields; Edward J. Roccella

From the National Heart, Lung, and Blood Institute (J.A.C., P.D.S., M.W., T.T., E.J.R.), National Institutes of Health, US Department of Health and Human Services, Bethesda, Md; and Pfizer, Inc (L.E.F.), New York, NY.

Correspondence to Paul D. Sorlie, National Heart, Lung, and Blood Institute, 6701 Rockledge Dr, MSC 7936, Bethesda, MD 20892. E-mail sorliep{at}mail.nih.gov

This study assesses trends in hypertension prevalence, blood pressure distributions and mean levels, and hypertension awareness, treatment, and control among US adults, age ≥18 years, between the third National Health and Nutrition Examination Survey (1988–1994) and the 1999–2004 National Health and Nutrition Examination Survey, a period of {approx}10 years. The age-standardized prevalence rate increased from 24.4% to 28.9% (P<0.001), with the largest increases among non-Hispanic women. Depending on gender and race/ethnicity, from one fifth to four fifths of the increase could be accounted for by increasing body mass index. Among hypertensive persons, there were modest increases in awareness (P=0.04), from 68.5% to 71.8%. The rate for men increased from 61.6% to 69.3% (P=0.001), whereas the rate for women did not change significantly. Rates remained higher for women than for men, although the difference narrowed considerably. Improvements in treatment and control rates were larger: 53.1% to 61.4% and 26.1% to 35.1%, respectively (both P<0.001). The greatest increases occurred among non-Hispanic white men and non-Hispanic black persons, especially men. Mexican American persons showed improvement in treatment and control rates, but these rates remained the lowest among race/ethnic subgroups (47.4% and 24.3%, respectively). Among all of the race/ethnic groups, women continued to have somewhat better awareness, treatment, and control, except for control rates among non-Hispanic white persons, which became higher in men. Differences between non-Hispanic black and white persons in awareness, treatment, and control were small. These divergent trends may translate into disparate trends in cardiovascular disease morbidity and mortality.


Key Words: hypertension • surveillance • trends • blood pressure • obesity


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