Hypertension, Vol 7, 457-468, Copyright © 1985 by American Heart Association
Estimates of the prevalence of hypertension in the United States have
varied owing to differences in interpretation and extrapolation of the
data. In 1978 the National High Blood Pressure Education Program issued a
consensus document estimating the prevalence of high blood pressure in the
United States. Results from the 1976-1980 National Health and Nutrition
Examination Survey (NHANES II) allow for a revised estimate. The purpose of
this report was to arrive at consensus on a prevalence figure and also to
provide information on the distribution of hypertension by blood pressure
level, age, race, and sex. The prevalence estimates used are based on
hypertension defined as blood pressure measurements greater than or equal
to 140/90 mm Hg (average of 3 readings taken on 1 occasion) or
self-reported taking of antihypertensive medication. Based on NHANES II
data, blacks have a higher prevalence than whites (38% vs 29%) and men show
a higher prevalence than women (33% vs 27%). These data again confirm the
tendency for the prevalence of hypertension to increase with age in the
U.S. population--this holds true for blacks, whites, men, and women.
Progress in high blood pressure control efforts has traditionally been
measured by changes in the status of awareness, treatment, and control.
Changing the hypertension threshold from 160/95 to 140/90 mm Hg, as
recently recommended, substantially lowers these measures: the percentage
of hypertensives aware of their condition falls from 74% to 54%, the
percentage taking antihypertensive medication falls from 56% to 33%, and
the percentage with controlled hypertension decreases from 34% to 11%.
These apparent decreases reflect a change in the frame of reference rather
than changes in hypertension treatment status. In addition, hypertension
prevalence rates from NHANES II (1976-1980) were applied to 1983 Bureau of
the Census population figures to estimate the total number of Americans
with hypertension and their distribution by age, sex, race, and severity of
blood pressure level. Since NHANES II did not include persons 75 years of
age or older in its sample, data from a pilot study on systolic
hypertension in the elderly were used for prevalence estimates in this age
group. Estimates for children under 6 years of age and hypertensive persons
controlling their pressures without medication could not be included in
this analysis because of a lack of reliable data on these groups.
ARTICLES
Hypertension prevalence and the status of awareness, treatment, and control in the United States. Final report of the Subcommittee on Definition and Prevalence of the 1984 Joint National Committee
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