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Prevalence, Awareness, Treatment, and Control of Hypertension Among United States Adults 1999–2004
Abstract
Detection of hypertension and blood pressure control are critically important for reducing the risk of heart attacks and strokes. We analyzed the trends in the prevalence, awareness, treatment, and control of hypertension in the United States in the period 1999–2004. We used the National Health and Nutrition Examination Survey 1999–2004 database. Blood pressure information on 14 653 individuals (4749 in 1999–2000, 5032 in 2001–2002, and 4872 in 2003–2004) aged ≥18 years was used. Hypertension was defined as blood pressure ≥140/90 mm Hg or taking antihypertensive medications. The prevalence of hypertension in 2003–2004 was 7.3±0.9%, 32.6±2.0%, and 66.3±1.8% in the 18 to 39, 40 to 59, and ≥60 age groups, respectively. The overall prevalence was 29.3%. When compared with 1999–2000, there were nonsignificant increases in the overall prevalence, awareness, and treatment rates of hypertension. The blood pressure control rate was 29.2±2.3% in 1999–2000 and 36.8±2.3% in 2003–2004. The age-adjusted increase in control rate was 8.1% (95% CI: 2.4 to 13.8%; P =0.006). The control rates increased significantly in both sexes, non-Hispanic blacks, and Mexican Americans. Among the ≥60 age group, the awareness, treatment, and control rates of hypertension had all increased significantly ( P ≤0.01). The improvement in blood pressure control is encouraging, although the prevalence of hypertension has not declined.
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“Two lower quality studies [405, 406] and five well-done studies [407–411] (13%, including one at a trend level), however, reported higher BP in the more R/S or with religious fasting.”
From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [405]
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“increased blood pressure accelerates age-related alterations to large arteries.(19,42,43)”
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“30% in middle-aged and elderly adults,(13) it is not surprising that approximately 11% of middle-aged adults have diabetes and 33% have hypertension, with the prevalence of these conditions increasing to 23% and 66%, respectively, by age 60 (Fig 2).(14,15) In the United States, these rates are highest among racial and…”
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“In humans, the incidence of hypertension, diabetes and atherosclerosis correlates with age (Figure 1A) [26,27].”
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“3% with a marked increase with rising age [13].”
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“The latest National Health and Nutrition Examination Survey reported control rates of 37% in the United States for 2003–2004, with only minor differences between men and women, between whites and blacks and among different age groups.(8) Earlier surveys in the same series reported control rates of 25% for 1990–1994.”
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“The treatment of hypertension, one of the main risk factors, reduces the number of adverse cardiovascular events and thus decreases the economic and health impact of hypertension related CV [4–6].”
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Two Self-management Interventions to Improve Hypertension Control
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“However, risk of hypertension is conclusively higher among African Americans in general (Ong et al., 2007), and the chronic stress of minority status is implicated in this link (Brondolo et al., 2008; Brondolo et al., 2003; Cozier et al., 2006; Roberts et al., 2008).”
BackgroundEarly physical activity promotes lower prevalence of chronic diseases in adulthood
Fernandes, R. A., & Zanesco, A. (2010) · Hypertension Research · doi:10.1038/hr.2010.106 · Cited by 196
Ambaw, A. D., Alemie, G. A., Woldeyohannes, S. M., & Mengesha, Z. B. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-282 · Cited by 192
“However, only 37% of hypertensive patients in a 2003-2004 survey were reported to have their blood pressure controlled [6].”
BackgroundJanero, D. R., & Makriyannis, A. (2009) · Expert Opinion on Emerging Drugs · doi:10.1517/14728210902736568 · Cited by 186
“Even highly efficacious cardiovascular drugs have proven insufficient to quench the metabolic syndrome’s negative impact on public health: for example, < 37% of high-blood-pressure patients in the United States attain long-term blood pressure control through antihypertensive therapy [38] .”
BackgroundCastetbon, K., Vernay, M., Malon, A., Salanave, B., Deschamps, V., Roudier, C., Oleko, A., Szego, E., & Herçberg, S. (2009) · British Journal Of Nutrition · doi:10.1017/s0007114509274745 · Cited by 200
Triple Antihypertensive Therapy With Amlodipine, Valsartan, and Hydrochlorothiazide
Calhoun, D. A., Lacourcière, Y., Chiang, Y. T., & Glazer, R. D. (2009) · Hypertension · doi:10.1161/hypertensionaha.109.131300 · Cited by 182
Yanes, L. L., & Reckelhoff, J. F. (2011) · American Journal of Hypertension · doi:10.1038/ajh.2011.71 · Cited by 190
“Prostaglandin F(2alpha) metabolite and F(2)isoprostane excretion rates in migraine.”
BackgroundDuration of Lactation and Incidence of Maternal Hypertension: A Longitudinal Cohort Study
Stuebe, A. M., Schwarz, E. B., Grewen, K., Rich-Edwards, J. W., Michels, K. B., Foster, E. M., Curhan, G., & Forman, J. (2011) · American Journal of Epidemiology · doi:10.1093/aje/kwr227 · Cited by 183
Association between periodontitis and arterial hypertension: a systematic review and meta-analysis
Martin-Cabezas, R., Seelam, N., Petit, C., Agossa, K., Gaertner, S., Tenenbaum, H., Davideau, J.-L., & Huck, O. (2016) · American Heart Journal · doi:10.1016/j.ahj.2016.07.018 · Cited by 183
Resistant hypertension—its identification and epidemiology
Sarafidis, P. A., Georgianos, P. I., & Bakris, G. L. (2012) · Nature Reviews Nephrology · doi:10.1038/nrneph.2012.260 · Cited by 183
Klotho Gene Delivery Prevents the Progression of Spontaneous Hypertension and Renal Damage
Wang, Y., & Sun, Z. (2009) · Hypertension · doi:10.1161/hypertensionaha.109.134320 · Cited by 183
Thethi, T. K., Kamiyama, M., & Kobori, H. (2012) · Current Hypertension Reports · doi:10.1007/s11906-012-0245-z · Cited by 184
The Effects of Insomnia and Sleep Loss on Cardiovascular Disease
Khan, M. S., & Aouad, R. (2017) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2017.01.005 · Cited by 185
Hyre, A. D., Krousel-Wood, M. A., Muntner, P., Kawasaki, L., & DeSalvo, K. B. (2007) · Journal of Clinical Hypertension · doi:10.1111/j.1524-6175.2007.06372.x · Cited by 174
Choi, H. M., Kim, H. C., & Kang, D. R. (2017) · PLoS ONE · doi:10.1371/journal.pone.0178334 · Cited by 174
Vitamin D deficiency and risk of cardiovascular diseases: a narrative review
Kheiri, B., Abdalla, A., Osman, M., Ahmed, S. A., Hassan, M., & Bachuwa, G. I. (2018) · Clinical Hypertension · doi:10.1186/s40885-018-0094-4 · Cited by 179
Differences in sleep between black and white adults: an update and future directions
Petrov, M. E. R., & Lichstein, K. L. (2015) · Sleep Medicine · doi:10.1016/j.sleep.2015.01.011 · Cited by 173
“Second, the assumption of treatment access and consistency across different ethnicities has proven untenable in multiple other domains such as hypertension and chronic pain [70,71].”
BackgroundDeFilippis, A. P., Young, R. L., McEvoy, J. W., Michos, E. D., Sandfort, V., Kronmal, R. A., McClelland, R. L., & Blaha, M. J. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw301 · Cited by 170
Epidemiology of hypertensive kidney disease
Udani, S., Lazich, I., & Bakris, G. L. (2011) · Nature Reviews Nephrology · doi:10.1038/nrneph.2010.154 · Cited by 171
“An analysis of data from the 1999–2004 National Health and Nutrition Examination Survey (NHANES) found that the prevalence of hypertension in the USA increased over these 5 years; prevalence rates were approximately 27% in 1999 and 29% in 2004”
MethodRao, M. V., Qiu, Y., Wang, C., & Bakris, G. L. (2008) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2007.12.012 · Cited by 173
Isolated Systolic Hypertension in the Elderly
Chobanian, A. V. (2007) · New England Journal of Medicine · doi:10.1056/nejmcp071137 · Cited by 167
Son, P. T., Quang, N. N., le Viet, N., Khai, P. G., Wall, S., Weinehall, L., Bonita, R., & Byass, P. (2011) · Journal of Human Hypertension · doi:10.1038/jhh.2011.18 · Cited by 166
Adane, A. A., Awoke, T., Alemu, S., & Zeleke, B. M. (2012) · BMC Cardiovascular Disorders · doi:10.1186/1471-2261-12-113 · Cited by 173
“3% prevalence report from the United States [10].”
BackgroundBlumenthal, J. A., Babyak, M. A., Sherwood, A., Craighead, L. W., Lin, P., Johnson, J. J., Watkins, L. L., Wang, J. T., Kuhn, C. M., Feinglos, M. N., et al. (2010) · Hypertension · doi:10.1161/hypertensionaha.109.149153 · Cited by 164
Predictors of Decline in Medication Adherence
Krousel-Wood, M. A., Joyce, C., Holt, E. W., Muntner, P., Webber, L. S., Morisky, D. E., Frohlich, E. D., & Ré, R. N. (2011) · Hypertension · doi:10.1161/hypertensionaha.111.176859 · Cited by 159
Genetic Variation and Adaptation in Africa: Implications for Human Evolution and DiseasePreprint
Gomez, F., Hirbo, J. B., & Tishkoff, S. A. (2014) · Cold Spring Harbor Perspectives in Biology · doi:10.1101/cshperspect.a008524 · Cited by 161
“In the United States, diseases like type 2 diabetes mellitus, hypertension, and prostate cancer are known to be more common in African Americans than European Americans (Landis et al. 1999; Brancati et al. 2000; Ong et al. 2007).”
BackgroundTemporal Trends in the Population Attributable Risk for Cardiovascular Disease
Cheng, S. C., Claggett, B. L., Correia, A. W., Shah, A. M., Gupta, D. K., Skali, H., Ni, H., Rosamond, W. D., HEISS, G. M., Folsom, A. R., et al. (2014) · Circulation · doi:10.1161/circulationaha.113.008506 · Cited by 163
Metadata
- Authors
- Ong, K. L., Cheung, B. M. Y., Man, Y. B., Lau, C. P., & Lam, K. S. L.
- Affiliations
- University of Hong Kong (HK)
- Venue
- Hypertension
- Published
- 2007-01
- Volume
- 49
- Issue
- 1
- Pages
- 69-75
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2122326747
- Cited by
- 1,395
- References
- 35
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 18 · 2023: 29 · 2022: 25 · 2021: 34 · 2020: 35 · 2019: 39 · 2018: 44 · 2017: 53 · 2016: 55 · 2015: 66 · 2014: 77 · 2013: 103 · 2012: 106
- FWCI
- 98.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- 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
- hypertension prevalence, hypertension awareness, antihypertensive therapy, blood pressure control, temporal trends, age differences, racial and ethnic differences, non-Hispanic blacks, Mexican Americans, adults
- MeSH terms
- Adult, Aging, Black or African American, Blood Pressure, Female, Goals, Humans, Hypertension, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Nutrition Surveys, United States, Prevalence, Mexican Americans, Black People
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