Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013;8(4):e60308.
doi: 10.1371/journal.pone.0060308. Epub 2013 Apr 5.

Prevalence, awareness, treatment, and control of hypertension in United States counties, 2001-2009

Casey Olives  1 , Rebecca Myerson, Ali H Mokdad, Christopher J L Murray, Stephen S Lim
Affiliations

Prevalence, awareness, treatment, and control of hypertension in United States counties, 2001-2009

Casey Olives et al. PLoS One. 2013.

Abstract

Hypertension is an important and modifiable risk factor for cardiovascular disease and mortality. Over the last decade, national-levels of controlled hypertension have increased, but little information on hypertension prevalence and trends in hypertension treatment and control exists at the county-level. We estimate trends in prevalence, awareness, treatment, and control of hypertension in US counties using data from the National Health and Nutrition Examination Survey (NHANES) in five two-year waves from 1999-2008 including 26,349 adults aged 30 years and older and from the Behavioral Risk Factor Surveillance System (BRFSS) from 1997-2009 including 1,283,722 adults aged 30 years and older. Hypertension was defined as systolic blood pressure (BP) of at least 140 mm Hg, self-reported use of antihypertensive treatment, or both. Hypertension control was defined as systolic BP less than 140 mm Hg. The median prevalence of total hypertension in 2009 was estimated at 37.6% (range: 26.5 to 54.4%) in men and 40.1% (range: 28.5 to 57.9%) in women. Within-state differences in the county prevalence of uncontrolled hypertension were as high as 7.8 percentage points in 2009. Awareness, treatment, and control was highest in the southeastern US, and increased between 2001 and 2009 on average. The median county-level control in men was 57.7% (range: 43.4 to 65.9%) and in women was 57.1% (range: 43.0 to 65.46%) in 2009, with highest rates in white men and black women. While control of hypertension is on the rise, prevalence of total hypertension continues to increase in the US. Concurrent increases in treatment and control of hypertension are promising, but efforts to decrease the prevalence of hypertension are needed.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Age-standardized prevalence of self-reported, total, and uncontrolled hypertension by sex among adults 30 years and older in 2001 and 2009.
Figure 2
Figure 2. Age-standardized prevalence of total hypertension by sex and race among adults 30 years and older in 2001 and 2009.
Figure 3
Figure 3. Age-standardized awareness, treatment, and control of hypertension by sex in adults 30 years and older in 2001 and 2009.
See this image and copyright information in PMC

References

    1. Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, et al. (2009) The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med 6: e1000058. - PMC - PubMed
    1. Perry HM, Roccella EJ (1998) Conference report on stroke mortality in the southeastern United States. Hypertension 31: 1206–15. - PubMed
    1. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, et al. (2012) Heart disease and stroke statistics–2012 update: a report from the American Heart Association. Circulation 125: e2–e220. - PMC - PubMed
    1. Wang TJ, Vasan RS (2005) Epidemiology of uncontrolled hypertension in the United States. Circulation 112: 1651–62. - PubMed
    1. Egan BM, Zhao Y, Axon RN (2010) US trends in prevalence, awareness, treatment, and control of hypertension, 1988–2008. JAMA 303: 2043–50. - PubMed

Publication types