Trends in blood pressure among adults with hypertension: United States, 2003 to 2012

Abstract

The aim of this study is to describe trends in the awareness, treatment, and control of hypertension; mean blood pressure; and the classification of blood pressure among US adults 2003 to 2012. Using data from the National Health and Nutrition Examination Survey 2003 to 2012, a total of 9255 adult participants aged ≥18 years were identified as having hypertension, defined as measured blood pressure ≥140/90 mm Hg or taking prescription medication for hypertension. Awareness and treatment among hypertensive adults were ascertained via an interviewer administered questionnaire. Controlled hypertension among hypertensive adults was defined as systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg. Blood pressure was categorized as optimal blood pressure, prehypertension, and stage I and stage II hypertension. Between 2003 and 2012, the percentage of adults with controlled hypertension increased (P-trend <0.01). Hypertensive adults with optimal blood pressure and with prehypertension increased from 13% to 19% and 27% to 33%, respectively (P-trend <0.01 for both groups). Among hypertensive adults who were taking antihypertensive medication, uncontrolled hypertension decreased from 38% to 30% (P-trend <0.01). Similarly, a decrease in mean systolic blood pressure was observed (P-trend <0.01); however, mean diastolic blood pressure remained unchanged. The trend in the control of blood pressure has improved among hypertensive adults resulting in a higher percentage with blood pressure at the optimal or prehypertension level and a lower percentage in stage I and stage II hypertension. Overall, mean systolic blood pressure decreased as did the prevalence of uncontrolled hypertension among the treated hypertensive population.

Keywords: blood pressure; epidemiology; hypertension; prevention and control; therapeutics.

Figure.

A–C, Age-adjusted awareness, treatment, and control of hypertension among adults with hypertension by sex and race/ethnicity (other racial/ethnic groups not shown separately), 2003 to 2004 through 2011 to 2012. A, Age standardization was computed by the direct method using weights based on the subpopulation of individuals with hypertension in The National Health and Nutrition Examination Survey (NHANES) 2007 to 2008. *P-trend <0.05. B, Age standardization was computed by the direct method using weights based on the subpopulation of individuals with hypertension in NHANES 2007 to 2008. *P-trend <0.05. C, Age standardization was computed by the direct method using weights based on the subpopulation of individuals with hypertension in NHANES 2007 to 2008. *P-trend <0.05.