Trends in Prevalence, Awareness, Management, and Control of Hypertension Among United States Adults, 1999 to 2010

Objectives The purpose of this study was to quantify the trends in blood pressure (BP), and the prevalence, awareness, management, and control of hypertension in U.S. adults (>= 20 years of age) from 1999 to 2010, and to assess the efficacy of current clinical measures in diagnosing and adequately treating hypertensive patients. Background Hypertension is a major independent risk factor for cardiovascular disease and stroke. Recent data indicate a decreasing trend in hypertension prevalence, along with improvements in hypertension awareness, management, and control. Methods The study used regression models to assess the trends in hypertension prevalence, awareness, management, and control from 1999 to 2010 among 28,995 male and female adults with BP measurements from a nationally representative sample of the noninstitutionalized U.S. population (National Health and Nutrition Examination Survey [NHANES] 1999 to 2010), with special attention given to 5,764 participants in NHANES 2009 to 2010. Results In 2009 to 2010, the prevalence of hypertension was 30.5% among men and 28.5% among women. The hypertension awareness rate was 69.7% (95% confidence interval [CI]: 62.0% to 77.4%) among men and 80.7% (95% CI: 74.5% to 86.8%) among women. The hypertension control rate was 40.3% (95% CI: 33.7% to 46.9%) for men and 56.3% (95% CI: 49.2% to 63.3%) for women. From 1999 to 2010, the prevalence of hypertension remained stable. Although hypertension awareness, management, and control improved, the overall rates remained poor (74.0% for awareness, 71.6% for management, 46.5% for control, and 64.4% for control in management); worse still, no improvement was shown from 2007 to 2010. Conclusions From 1999 to 2010, prevalence of hypertension remained stable. Hypertension awareness, management, and control were improved, but remained poor; nevertheless, there has been no improvement since 2007. (J Am Coll Cardiol 2012; 60: 599-606) (C) 2012 by the American College of Cardiology Foundation