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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 [1-6]. 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 (figure 1). 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 29 percent of adults 18 years and older in the United States had hypertension [2,3,5,7-9], and, based upon the size of the adult population, this translates into 72 million adults with hypertension. The prevalence of hypertension among adults in the United States has remained relatively constant since 1999 [5,6] and is higher than the nadir of 24 percent between 1988 and 1994 [1,3,5,6,8,10].

One possible explanation for the increased prevalence of hypertension from 1988 through 1994 to more recent surveys may be the marked increase in obesity and average body mass index [2]. It is estimated, for example, that one-half of the relative increased prevalence of hypertension may be due to an increased weight of the average individual.

Estimates of hypertension prevalence among adults from 90 countries worldwide (approximately 31 percent in 2010) are similar to those in the United States [10]. 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) [7,11].

    
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Literature review current through: Sep 2017. | This topic last updated: Jun 12, 2017.
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