Prevalence and trends of prehypertension and hypertension in United States: National Health and Nutrition Examination Surveys 1976 to 2000

Background: The Seventh Report of the Joint National Committee (JNC-7) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure provided a new classification of blood pressure for adults aged >= 18 years to guide screening and treatment efforts. Material/Methods: Using the new classification, we examined trends and prevalence of pre-hypertension (120-139/80-89 mm Hg), stage 1 hypertension (140-159/90-99 mm Hg), and stage 2 hypertension (>= 160/100 mm Hg) in a nationally representative sample of the United States population. We analyzed 4115 adult persons from 1999 and 2000 National Health and Nutrition Examination Survey (NHANES), 20,322 persons from NHANES II (1976-1980) and 30,818 persons from NHANES III (1988-1992). Results: In the United States population aged 20 or greater, we found that an estimated 41.9 million men and 27.8 million women have pre-hypertension, 12.8 million men and 12.2 million women have stage 1 hypertension, and 4.1 million men and 6.9 million women have stage 2 hypertension. Age-and sex-adjusted rates of pre-hypertension increased among non-Hispanic Write, African American, and Hispanic persons between 1988-1992 and 1999-2000. Age- and sex-adjusted rates of stage I hypertension increased among Hispanics between 1988-1992 and 1999-2000. Age- and sex-adjusted rates of stage 2 hypertension decreased among non-Hispanic Whites between 1988-1992 and 1999-2000, but were unchanged for African American and Hispanic persons. Conclusions: With over a 100 million persons with pre-hypertension or hypertension in the United States, a renewed effort directed towards screening, education, and treatment is required, particularly in the Hispanic population.