The Prevalence of Prehypertension and Hypertension Among US Adults According to the New Joint National Committee Guidelines: New Challenges of the Old Problem
Abstract
BACKGROUND: The recently released Seventh Report of the Joint National Committee (JNC) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure provides a new classification of blood pressure levels. Little is known about the current situation of elevated blood pressure in the United States, according to the new guidelines. METHODS: Cross-sectional analysis of national representative data collected from 4805 adults 18 years and older surveyed in the 1999-2000 National Health and Nutrition Examination Survey. We examined the prevalence of prehypertension and hypertension according to the new JNC guidelines, people's awareness and management of hypertension, and the differences across sociodemographic and body weight groups. RESULTS: Elevated blood pressure is a serious problem in the United States. Approximately 60% of American adults have prehypertension or hypertension, and some population groups, such as African Americans, older people, low-socioeconomic-status groups, and overweight groups, are disproportionately affected. The prevalence of hypertension has increased by approximately 10 percentage points during the past decade. The awareness and appropriate management of hypertension among hypertensive patients remain low: 31% were not aware of their disease, only two thirds (66%) were told by health professionals to adopt lifestyle modifications or take drugs to control hypertension, and only 31% controlled their hypertension. CONCLUSIONS: With 60% of the population affected, the United States is facing a serious challenge in the prevention and management of prehypertension and hypertension. People's awareness and control of hypertension remain poor. This study highlights the seriousness of the problem and the importance of promoting lifestyle modifications.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
For people without diabetes, losing weight and being more active may postpone and perhaps prevent diabetes.
“In nondiabetic individuals, weight loss and increased physical activity can delay the onset of and possibly prevent diabetes.22,23”
From Diet and Lifestyle Recommendations Revision 2006: A Scientific Statement From the American Heart Association Nutrition Committee (2006) · cites this paper as [22]
In NHANES, the prevalence of hypertension among obese individuals (BMI ≥30 kg/m2) is 42.5%, compared with 27.8% for overweight individuals (BMI 25.0-29.9 kg/m2) and 15.3% for those with BMI <25 kg/m2.
“Recent data from NHANES indicate that the prevalence of hypertension among obese individuals, with a BMI 30 kg ⁄ m 2 , is 42.5% compared with 27.8% for overweight individuals (BMI 25.0-29.9kg ⁄ m 2 ) and 15.3% for those with BMI <25 kg ⁄ m 2 .52”
Cites
(1997) · Archives of Internal Medicine · doi:10.1001/archinte.157.21.2413 · Cited by 6,345 · see citing works
Prevalence and trends in obesity among US adults, 1999–2000
Flegal, K. M. (2002) · JAMA · doi:10.1001/jama.288.14.1723 · Cited by 6,190 · see citing works
Wolf-Maier, K. (2003) · JAMA · doi:10.1001/jama.289.18.2363 · Cited by 1,718 · see citing works
Human blood pressure determination by sphygmomanometry.
Perloff, D., Grim, C. M., Flack, J. M., Frohlich, E. D., Hill, M. D., McDonald, M., & Morgenstern, B. Z. (1993) · Circulation · doi:10.1161/01.cir.88.5.2460 · Cited by 1,592 · see citing works
Burt, V. L., Cutler, J. A., HIGGINS, M. W., Horan, M. J., Labarthe, D. R., Whelton, P. K., Brown, C., & Roccella, E. J. (1995) · Hypertension · doi:10.1161/01.hyp.26.1.60 · Cited by 1,252 · see citing works
Cardiovascular prevention and blood pressure reduction
Staessen, J. A., Wang, J., & Thijs, L. (2003) · Journal of Hypertension · doi:10.1097/00004872-200306000-00002 · Cited by 482 · see citing works
The National High Blood Pressure Education Program
Jones, D. W., & Hall, J. E. (2002) · Hypertension · doi:10.1161/01.hyp.0000018303.61360.28 · Cited by 279 · see citing works
Factors Associated With Hypertension Control in the General Population of the United States
He, J., Muntner, P., Chen, J., Roccella, E. J., Streiffer, R. H., & Whelton, P. K. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.9.1051 · Cited by 261 · see citing works
Chobanian, A. V., Bakris, G. L., & Black, H. R. (2003) · ACC Current Journal Review · doi:10.1016/s1062-1458(03)00270-8 · Cited by 239 · see citing works
Distribution of blood pressure and hypertension in Canada and the United States
Joffres, M. R. (2001) · American Journal of Hypertension · doi:10.1016/s0895-7061(01)02211-7 · Cited by 219 · see citing works
Age-specific relevance of usual blood pressure to vascular mortality
Lewington, S., Clarke, R., Qizilbash, N., Peto, R., & Collins, R. (2003) · The Lancet · doi:10.1016/s0140-6736(03)13064-4 · Cited by 197 · see citing works
Wolf-Maier, K., Cooper, R., & Banegas, J. R. (2003) · ACC Current Journal Review · doi:10.1016/s1062-1458(03)00271-x · Cited by 171 · see citing works
Detection and Control of High Blood Pressure in the Community
Meissner, I., Whisnant, J. P., Sheps, S. G., Schwartz, G. L., O’Fallon, W. M., Covalt, J. L., Sicks, J. D., Bailey, K. R., & Wiebers, D. O. (1999) · Hypertension · doi:10.1161/01.hyp.34.3.466 · Cited by 121 · see citing works
The Urgent Need to Improve Hypertension Care
Trilling, J. S. (2000) · Archives of Family Medicine · doi:10.1001/archfami.9.9.794 · Cited by 75 · see citing works
Detection and Control of Hypertension in the Population The United States Experience
Mulrow, P. J. (1998) · American Journal of Hypertension · doi:10.1016/s0895-7061(98)00066-1 · Cited by 45 · see citing works
Whyte, J. L., Lapuerta, P., L'Italien, G. J., et al. (2001) · Journal of Clinical Hypertension · doi:10.1111/j.1524-6175.2001.00461.x · Cited by 43 · see citing works
Age-specific relevance of usual blood pressure to vascular mortality
Jennrich, R. I. (2003) · The Lancet · doi:10.1016/s0140-6736(03)13062-0 · Cited by 27 · see citing works
Undertreatment of Hypertension: A Dozen Reasons
Gupta, K., & Gupta, S. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.19.2246 · Cited by 21 · see citing works
Obesity and Blood Pressure Regulation
Rocchini, A. P. (2003) · CRC Press eBooks · doi:10.3109/9780203913376-40 · Cited by 19 · see citing works
No Surprises in Blood Pressure Awareness Study Findings
Moser, M. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.6.654 · Cited by 9 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Lichtenstein, A. H., Appel, L. J., Brands, M., Carnethon, M., Daniels, S., Franch, H. A., Franklin, B., Kris-Etherton, P., Harris, W. S., Howard, B., et al. (2006) · Circulation · doi:10.1161/circulationaha.106.176158 · Cited by 2,705 · see citing works
Role of the T cell in the genesis of angiotensin II–induced hypertension and vascular dysfunction
Guzik, T. J., Hoch, N. E., Brown, K. A., McCann, L. A., Rahman, A., Dikalov, S., Goronzy, J., Weyand, C., & Harrison, D. G. (2007) · The Journal of Experimental Medicine · doi:10.1084/jem.20070657 · Cited by 1,736 · see citing works
Appel, L. J., Brands, M. W., Daniels, S. R., Karanja, N., Elmer, P. J., & Sacks, F. M. (2006) · Hypertension · doi:10.1161/01.hyp.0000202568.01167.b6 · Cited by 1,304 · see citing works
Cook, N. R., Cutler, J. A., Obarzanek, E., Buring, J. E., Rexrode, K. M., Kumanyika, S. K., Appel, L. J., & Whelton, P. K. (2007) · BMJ · doi:10.1136/bmj.39147.604896.55 · Cited by 1,179 · see citing works
Appel, L. J., Sacks, F. M., Carey, V. J., Obarzanek, E., Swain, J. F., Miller, E. R., Conlin, P. R., Erlinger, T. P., Rosner, B. A., Laranjo, N. M., et al. (2005) · JAMA · doi:10.1001/jama.294.19.2455 · Cited by 1,170 · see citing works
Seravalle, G., & Grassi, G. (2017) · Pharmacological Research · doi:10.1016/j.phrs.2017.05.013 · Cited by 909 · see citing works
Landsberg, L., Aronne, L. J., Beilin, L. J., Burke, V., Igel, L. I., Lloyd‐Jones, D., & Sowers, J. (2013) · The Journal of Clinical Hypertension · doi:10.1111/jch.12049 · Cited by 528 · see citing works
Dikalov, S. I., & Nazarewicz, R. R. (2013) · Antioxidants & Redox Signaling · doi:10.1089/ars.2012.4604 · Cited by 356 · see citing works
CYP1A2 genotype modifies the association between coffee intake and the risk of hypertension
Palatini, P., Ceolotto, G., Ragazzo, F., Dorigatti, F., Saladini, F., Papparella, I., Mos, L., Zanata, G., & Santonastaso, M. (2009) · Journal of Hypertension · doi:10.1097/hjh.0b013e32832ba850 · Cited by 230 · see citing works
Jayalath, V. H., de Souza, R. J., Sievenpiper, J. L., Ha, V., Chiavaroli, L., Mirrahimi, A., Di Buono, M., Bernstein, A. M., Leiter, L. A., Kris-Etherton, P. M., et al. (2014) · American Journal of Hypertension · doi:10.1093/ajh/hpt155 · Cited by 173 · see citing works
DASH lowers blood pressure in obese hypertensives beyond potassium, magnesium and fibre
Al-Solaiman, Y., Jesri, A., Mountford, W. K., Lackland, D. T., Zhao, Y., & Egan, B. M. (2010) · Journal of Human Hypertension · doi:10.1038/jhh.2009.58 · Cited by 129 · see citing works
Whole grains and incident hypertension in men.
Flint, A. J., Hu, F. B., Glynn, R. J., Jensen, M. K., Franz, M., Sampson, L., & Rimm, E. B. (2009) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.27460 · Cited by 126 · see citing works
ASH Position Paper: Dietary Approaches to Lower Blood Pressure
Appel, L. J., & on Behalf of the American Society of Hypertension Writing Group (2009) · The Journal of Clinical Hypertension · doi:10.1111/j.1751-7176.2009.00136.x · Cited by 109 · see citing works
Martínez-Sámano, J., Torres-Montes de Oca, A., Luqueño-Bocardo, O. I., Torres-Durán, P. V., & Juárez-Oropeza, M. A. (2018) · doi:10.20944/preprints201811.0283.v1 · Cited by 73 · see citing works
ASH position paper: Dietary approaches to lower blood pressure
Appel, L. J. (2009) · Journal of the American Society of Hypertension · doi:10.1016/j.jash.2009.08.003 · Cited by 67 · see citing works
Coxson, P. G., Cook, N. R., Joffres, M., Hong, Y., Orenstein, D., Schmidt, S. M., & Bibbins-Domingo, K. (2013) · Hypertension · doi:10.1161/hypertensionaha.111.201293 · Cited by 65 · see citing works
Hall, J. M., Xu, J., Walsh, M. G., Cho, H.-D., Harrell, G., Keshwani, S. A., Smith, S. M., & Staras, S. A. S. (2025) · PLOS One · doi:10.1371/journal.pone.0326776 · Cited by 4 · see citing works
- Authors
- Wang, Y., & Wang, Q. J.
- Affiliations
- University of Illinois Chicago (US)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2004-10-25
- Volume
- 164
- Issue
- 19
- Pages
- 2126
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2089804373
- Cited by
- 572
- References
- 22
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 13 · 2023: 10 · 2022: 14 · 2021: 14 · 2020: 16 · 2019: 17 · 2018: 25 · 2017: 31 · 2016: 25 · 2015: 32 · 2014: 24 · 2013: 34 · 2012: 45
- FWCI
- 23.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK063383, 1R01 DK63383-01)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- prehypertension, hypertension, blood pressure prevalence, JNC 7 guidelines, hypertension awareness, hypertension control, antihypertensive therapy, African Americans, socioeconomic status, overweight, lifestyle modification, hypertension prevention, NHANES
- MeSH terms
- Adult, Attitude to Health, Awareness, Body Weight, Cross-Sectional Studies, Demography, Female, Humans, Hypertension, Male, Socioeconomic Factors, United States, Prevalence, Practice Guidelines as Topic, Disease Progression
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
