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The prevalence and control of hypertension in adults

Author
Brent M Egan, MD
Section Editor
George L Bakris, MD
Deputy Editors
Daniel J Sullivan, MD, MPH
John P Forman, MD, MSc

PREVALENCE OF HYPERTENSION

The National Health and Nutrition Examination Surveys (NHANES) have provided important epidemiologic information on the prevalence and control of hypertension in the United States between 1960 and 2014 [1-7]. Overall, the prevalence is higher in individuals who are 60 years and older as compared with younger adults and is higher in non-Hispanic blacks compared with non-Hispanic whites and Hispanics. The prevalence of hypertension in children is discussed separately. (See "Definition and diagnosis of hypertension in children and adolescents".)

It remains unclear why non-Hispanic blacks are more likely to become hypertensive. Both genetic and environmental factors are probably important, one of which may be a greater likelihood of low birth weight, which appears to predict higher pressures in adulthood. (See "Possible role of low birth weight in the pathogenesis of primary (essential) hypertension" and "Treatment of hypertension in blacks".)

NHANES data from 2011 to 2014 demonstrated that 46 percent of adults 18 years and older in the United States had hypertension (defined as a systolic pressure ≥130 mmHg and/or a diastolic pressure ≥80 mmHg) [1]. Based upon the size of the adult population, this translates into 103 million adults with hypertension. Prior to the redefinition of hypertension by the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, the prevalence of hypertension (defined as a systolic pressure ≥140 mmHg and/or a diastolic pressure ≥90 mmHg) was 32 percent [8] and had remained relatively constant since 1999 [6,7]. (See "Overview of hypertension in adults", section on 'Definitions'.)

Using the prior definition of hypertension, prevalence estimates among adults from 90 countries worldwide (approximately 31 percent in 2010) were similar to those in the United States [9]. In surveys similar to NHANES that were performed in Canada and Europe, the age- and sex-adjusted prevalence of hypertension (defined as 140/90 mmHg or higher) ranged from 20 to 55 percent (figure 1) [10,11].

The estimated global prevalence of hypertension is high. In a review, pooled data suggested that 26 percent of the world's adult population (972 million) had hypertension, using the prior definition, in the year 2000 [12]. In 2010, this estimate increased to 31 percent of the global population, or 1.39 billion people [13]. Rates were higher in low- and middle-income (31.5 percent) than in high-income (28.5 percent) countries. Long-term projections suggest that, by 2025, 29 percent of adults worldwide would have hypertension (ie, 1.56 billion people globally) [12].

    
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Literature review current through: Nov 2017. | This topic last updated: Nov 20, 2017.
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