http://bmj.bmjjournals.com/cgi/content/full/327/7407/120-b

BMJ  2003;327:120 (19 July)
 

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Hypertension is increasing in United States

Janice Hopkins Tanne

New York

Hypertension in the United States increased during the 1990s and now affects more than a quarter of the population. Less than a quarter of those affected have their hypertension under control.

Hypertension was most common among non-Hispanic black Americans, those aged 60 or older, and women Credit: STUART RAMSON/AP

An analysis of the national health and nutrition examination survey (NHANES) published in JAMA showed that 29% of Americans—more than 58 million people—have hypertension, defined as 140/90 mm Hg or above ( JAMA 2003;29: 199-206).

Between the 1988-91 survey and the 1999-2000 survey, hypertension increased by 3.7% (95% confidence interval 0% to 8.3%).

More than half the increase (2%) is due to an increase in body mass index, even after adjustment for age, sex, and race or ethnicity, say the investigators, Dr Ihab Hajjar of Palmetto Health Richland, University of South Carolina, Columbia, and Dr Theodore Kotchen of the Medical College of Wisconsin, Milwaukee.

The survey is based on home interviews of a representative sample of Americans. Participants also have their blood pressure measured by health workers at the same time. Surveys from 1960 to 1991 had shown a decrease in hypertension.

Dr Hajjar told the BMJ: "According to the multivariate analysis, age, being African American, and higher body mass index were associated with having hypertension."

Hypertension prevalence was highest in non-Hispanic black Americans (34%), those aged 60 or older (65%), and women (30%).

Control of hypertension was poor. Most (69%) people with hypertension were aware of the problem and most (58%) were receiving medication. Just over half of those taking medication (53%) had their hypertension controlled. Nearly three quarters of people with diabetes and hypertension did not have their blood pressure controlled at the recommended level of less than 130/85 mm Hg.

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