Cited by 1,395Blood Pressure and Hypertension StudiesSodium Intake and HealthHealth Promotion and Cardiovascular Prevention

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Prevalence, Awareness, Treatment, and Control of Hypertension Among United States Adults 1999–2004

Ong, Kwok Leung, Cheung, Bernard M.Y., Man, Yu Bun, Lau, Chu Pak, Lam, Karen S.L.·2007·Hypertension

DOI 10.1161/01.hyp.0000252676.46043.18

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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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Leenen, F. H. H., McInnis, N. H., & Fodor, G. J. (2010) · American Journal of Hypertension · doi:10.1038/ajh.2010.93 · Cited by 32
Hypertension Control
Kotchen, T. A. (2006) · Hypertension · doi:10.1161/01.hyp.0000250394.05703.06 · Cited by 32
The Effects of an Olmesartan Medoxomil–Based Treatment Algorithm on 24‐Hour Blood Pressure Levels in Elderly Patients Aged 65 and Older
Kereiakes, D. J., Neutel, J., Stoakes, K. A., Waverczak, W. F., Xu, J., Shojaee, A., & Dubiel, R. (2009) · Journal of Clinical Hypertension · doi:10.1111/j.1751-7176.2009.00147.x · Cited by 30
Effect of cardiometabolic risk factors on hypertension management: a cross-sectional study among 28 physician practices in the United States
Belletti, D. A., Zacker, C., & Wogen, J. (2010) · Cardiovascular Diabetology · doi:10.1186/1475-2840-9-7 · Cited by 31
“Almost one-third of adults in the US (29.3%) had hypertension during 2003-04 [ 1 ].”
BackgroundInfluential
Cardiovascular Risk Factor Management Performance in Canada and the United States: A Systematic Review
Alabousi, M., Abdullah, P., Alter, D. A., Booth, G. L., Hogg, W., Ko, D. T., Manuel, D. G., Farkouh, M. E., Tu, J. V., & Udell, J. A. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2016.07.005 · Cited by 31
The Relationship Between Cognitive Functioning and the JNC-8 Guidelines for Hypertension in Older Adults
Goldstein, F. C., Hajjar, I. M., Dunn, C. B., Levey, A. I., & Wharton, W. (2016) · The Journals of Gerontology Series A · doi:10.1093/gerona/glw181 · Cited by 32
Current concepts in combination therapy for the treatment of hypertension: combined calcium channel blockers and RAAS inhibitors
Rubio-Guerra, A. F. (2009) · Integrated Blood Pressure Control · doi:10.2147/ibpc.s6232 · Cited by 30
Racial/Ethnic Variability in Hypertension Prevalence and Risk Factors in National Health Interview Survey
Holmes, L., Hossain, J., Ward, D., & Opara, F. (2012) · ISRN Hypertension · doi:10.5402/2013/257842 · Cited by 31
“Unlike other studies [7, 18, 21, 22], that have shown that racial/ethnic differences in hypertension prevalence between non-Hispanic blacks and non-Hispanic whites are removed by controlling for socio-demographic variables (income, occupation, and poverty level), racial difference in hypertension prevalence between no…”
Result
Improved persistence and adherence to diuretic fixed-dose combination therapy compared to diuretic monotherapy
Patel, B. V., Remigio‐Baker, R. A., Thiebaud, P., Preblick, R., & Plauschinat, C. A. (2008) · BMC Family Practice · doi:10.1186/1471-2296-9-61 · Cited by 31
“Only 37% of patients with hypertension, and only slightly more than half (57%) of those receiving antihypertensive treatment currently have their blood pressure (BP) controlled [1].”
Background
Baseline medication adherence and blood pressure in a 24‐month longitudinal hypertension study
Shaw, R. J., & Bosworth, H. B. (2011) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2011.03859.x · Cited by 31
Efficacy of Patient Activation Interventions With or Without Financial Incentives to Promote Prescribing of Thiazides and Hypertension Control
Kaboli, P. J., Howren, M. B., Ishani, A., Carter, B. L., Christensen, A. J., & Weg, M. W. V. (2018) · JAMA Network Open · doi:10.1001/jamanetworkopen.2018.5017 · Cited by 30
Trends in the Prevalence of Hypertension in Island and Coastal Areas of China: A Systematic Review With Meta-Analysis
Chen, X., Wei, W., Zou, S., Wu, X., Zhou, B., Fu, L., Wang, H., & Shi, J. (2014) · American Journal of Hypertension · doi:10.1093/ajh/hpu026 · Cited by 30
Elevations in serum creatinine with RAAS blockade: why isnʼt it a sign of kidney injury?
Ryan, M. J., & Tuttle, K. R. (2008) · Current Opinion in Nephrology & Hypertension · doi:10.1097/mnh.0b013e32830a9606 · Cited by 30
Non-Adherence Related Factors to Antihypertensive Medications Among Hypertensive Patients on Follow up at Nedjo General Hospital in West Ethiopia
Berisa, H. D., & Dedefo, M. G. (2018) · The Open Public Health Journal · doi:10.2174/1874944501811010062 · Cited by 30
Comparing the income-related inequity of tested prevalence and self-reported prevalence of hypertension in China
Su, M., Si, Y., Zhou, Z., Shen, C., Dong, W., Fan, X., Wang, X., & Wei, X. (2018) · International Journal for Equity in Health · doi:10.1186/s12939-018-0796-y · Cited by 31
“However, hypertension can be asymptomatic, and many patients living with hypertension may have not seen a doctor [6, 7].”
BackgroundMethod
Characteristics of hypertensive Canadians not receiving drug therapy
Campbell, N. R. C., So, L., Amankwah, E. K., Quan, H., & Maxwell, C. J. (2008) · Canadian Journal of Cardiology · doi:10.1016/s0828-282x(08)70623-8 · Cited by 30
Subgroup Analyses of an Efficacy and Safety Study of Concomitant Administration of Amlodipine Besylate and Olmesartan Medoxomil: Evaluation by Baseline Hypertension Stage and Prior Antihypertensive Medication Use
Oparil, S., Lee, J., Karki, S., & Melino, M. R. (2009) · Journal of Cardiovascular Pharmacology · doi:10.1097/fjc.0b013e3181bad74e · Cited by 29
Aging and obesity are associated with undiagnosed hypertension in a cohort of males in the Central Province of Sri Lanka: a cross-sectional descriptive study
Jayawardana, N. W. I. A., Jayalath, W. A. T. A., Madhujith, W. M. T., Ralapanawa, U., Jayasekera, R. S., Alagiyawanna, S. A. S. B., Bandara, A. M. K. R., & Kalupahana, N. S. (2017) · BMC Cardiovascular Disorders · doi:10.1186/s12872-017-0600-8 · Cited by 30
Targeting mechanisms of hypertensive vascular disease with dual calcium channel and renin–angiotensin system blockade
Weir, M. R. (2007) · Journal of Human Hypertension · doi:10.1038/sj.jhh.1002254 · Cited by 30
Overcoming clinical inertia to achieve blood pressure goals: the role of fixed-dose combination therapy
Basile, J., & Neutel, J. (2009) · Therapeutic Advances in Cardiovascular Disease · doi:10.1177/1753944709356012 · Cited by 30
“BP control rates are particularly poor in certain populations, including Blacks and obese patients, as well as those with diabetes, who have more stringent BP goals due to an elevated risk of cardiovascular and renal disease (Table 2) [Ong et al. 2007].”
BackgroundMethodInfluential
Losartan reverses impaired osseointegration in spontaneously hypertensive rats
Mulinari‐Santos, G., Batista, F. R. D. S., Kirchweger, F., Tangl, S., Gruber, R., & Okamoto, R. (2018) · Clinical Oral Implants Research · doi:10.1111/clr.13376 · Cited by 29
In Aged Females, the Enhanced Pressor Response to Angiotensin II Is Attenuated By Estrogen Replacement via an Angiotensin Type 2 Receptor-Mediated Mechanism
Barsha, G., Colafella, K. M. M., Walton, S. L., Gaspari, T. A., Spizzo, I., Pinar, A. A., Hilliard, L. M., Widdop, R. E., Samuel, C. S., & Denton, K. M. (2021) · Hypertension · doi:10.1161/hypertensionaha.121.17164 · Cited by 29
Validity and Concordance Between Self-Reported and Clinical Diagnosis of Hypertension Among Elderly Residents in Northeastern Brazil
de Menezes, T. N., Oliveira, E. C. T., & Fischer, M. A. T. D. S. (2013) · American Journal of Hypertension · doi:10.1093/ajh/hpt181 · Cited by 29
Alpha‐adrenergic receptor gene polymorphisms and cardiovascular reactivity to stress in B lack adolescents and young adults
Kelsey, R. M., Alpert, B. S., Dahmer, M. K., Krushkal, J., & Quasney, M. W. (2011) · Psychophysiology · doi:10.1111/j.1469-8986.2011.01319.x · Cited by 29
Angiotensin Receptor Blocker and Dihydropyridine Calcium Channel Blocker Combinations: An Emerging Strategy in Hypertension Therapy
Oparil, S., & Weber, M. A. (2009) · Postgraduate Medicine · doi:10.3810/pgm.2009.03.1974 · Cited by 29
Self‐reported Comorbidities Among Self‐described Overweight African‐American and Hispanic Adults in the United States: Results of a National Survey
Burroughs, V. J., Nonas, C., Sweeney, C. T., Rohay, J. M., Harkins, A. M., Kyle, T. K., & Burton, S. L. (2008) · Obesity · doi:10.1038/oby.2008.61 · Cited by 29
Improving Hypertension Quality Measurement Using Electronic Health Records
Persell, S. D., Kho, A., Thompson, J. A., & Baker, D. W. (2009) · Medical Care · doi:10.1097/mlr.0b013e31818b070c · Cited by 29
Identifying predictors of blood pressure control in the Lebanese population - a national, multicentric survey – I-PREDICT
Mallat, S. G., Samra, S. A., Younes, F. C., & Sawaya, M.-T. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-1142 · Cited by 29
“The overall BP control rate, after 6 months, in this cohort, is higher than international studies’ rates [15,38,39].”
BackgroundResult
Effects of Chinese herbal medicine Yiqi Huaju Formula on hypertensive patients with metabolic syndrome: a randomized, placebo-controlled trial
Chen, Y., Fu, D., Chen, Y., He, Y., Xiao-dong, F., Xu, Y., Liu, Y., Feng, X., Zhang, T., & Wang, W. (2013) · Journal of Chinese Integrative Medicine · doi:10.3736/jintegrmed2013031 · Cited by 29
Combined therapy in the treatment of hypertension
Escobar, C., & Barrios, V. (2009) · Fundamental and Clinical Pharmacology · doi:10.1111/j.1472-8206.2009.00749.x · Cited by 29
Trends in stroke subtypes and vascular risk factors in a stroke center in China over 10 years
Tian, D., Yang, Q., Dong, Q. S., Li, N., Yan, B., & Fan, D. (2018) · Scientific Reports · doi:10.1038/s41598-018-23356-9 · Cited by 29
“Based on previous community studies, the hypertension control rate is 9.3% in China compared with 33.1% in America and is also much lower than in several other Asian countries such as Korea, Thailand, and Iran 18,21,22 .”
ResultInfluential
Self-reported hypertension in Northern China: a cross-sectional study of a risk prediction model and age trends
Du, M., Yin, S., Wang, P., Wang, X., Wu, J., Xue, M., Zheng, H., Zhang, Y., Liang, D., Wang, R., et al. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-3279-3 · Cited by 29
Physician Adherence to Blood Pressure Guidelines and Its Effect on Seniors
Milchak, J. L., Carter, B. L., Ardery, G., Dawson, J. D., Harmston, M., & Franciscus, C. L. (2008) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1592/phco.28.7.843 · Cited by 29
Impact of supportive measures on drug adherence in patients with essential hypertension treated with valsartan: the randomized, open-label, parallel group study VALIDATE
Düsing, R., Handrock, R., Klebs, S. H. G., Tousset, E., & Vrijens, B. (2009) · Journal of Hypertension · doi:10.1097/hjh.0b013e328323f9be · Cited by 29
Prevalence and determinants of prehypertension among African Surinamese, Hindustani Surinamese, and White Dutch in Amsterdam, the Netherlands: the SUNSET study
Agyemang, C. O., van Valkengoed, I. G. M., van den Born, B. H., & Stronks, K. (2007) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/hjr.0b013e32828621df · Cited by 28
Contributions of a Local Health Examination Survey to the Surveillance of Chronic and Infectious Diseases in New York City
Gwynn, R. C., Garg, R. K., Kerker, B. D., Frieden, T. R., & Thorpe, L. E. (2008) · American Journal of Public Health · doi:10.2105/ajph.2007.117010 · Cited by 30
Validity of Self-reported Hypertension and Factors Related to Discordance Between Self-reported and Objectively Measured Hypertension: Evidence From a Cohort Study in Iran
Najafi, F., Pasdar, Y., Shakiba, E., Hamzeh, B., Darbandi, M., Moradinazar, M., Navabi, J., Anvari, B., Saidi, M. R., & Bazargan‐Hejazi, S. (2019) · Journal of Preventive Medicine and Public Health · doi:10.3961/jpmph.18.257 · Cited by 28

Authors: Ong, K. L., Cheung, B. M. Y., Man, Y. B., Lau, C. P., & Lam, K. S. L.
Affiliations: University of Hong Kong (HK)
ORCID: Ong, Kwok Leung
Cheung, Bernard M.Y.
Lau, Chu Pak
Lam, Karen S.L.
Venue: Hypertension
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2007-01
Volume: 49
Issue: 1
Pages: 69-75
ISSN: 0194-911X (ISSN-L)
1524-4563
DOI: 10.1161/01.hyp.0000252676.46043.18
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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Prevalence, Awareness, Treatment, and Control of Hypertension Among United States Adults 1999–2004

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