85 - Hypertension prevalence time trends in the US population: examination of NHANES 1999 – 2023
Description/Abstract/Artist Statement
Background: Hypertension is a modifiable risk factor for cardiovascular disease and a significant contributor to morbidity and mortality worldwide. In the United States, estimates from the National Health and Nutrition Examination Survey (NHANES) and American Heart Association (AHA) suggest that 103.8 million, or 45% of American adults, may meet the clinical criteria for hypertension, posing a substantial public health challenge[1]. Over the past two decades, significant efforts have been made in screening, educating, and treating patients for high blood pressure, yet the effectiveness of these efforts may vary across demographic and socioeconomic groups[2] [3].
Methods: This study used data from 75,070 participants in the National Health and Nutrition Examination Survey (NHANES), spanning 1999–2023. Hypertension was defined as systolic blood pressure (BP) ≥140 mmHg, diastolic BP ≥90 mmHg, or current antihypertensive medication use. Participants with BP in the hypertensive range but without treatment or prior diagnosis of hypertension were categorized as having undiagnosed hypertension. Model adjustments included age, gender, race/ethnicity, family income-to-poverty ratio (FIPR), and survey cycle.
Results: The overall prevalence of hypertension was 30.7% (95% CI: 30.0–31.5). Although the unadjusted prevalence appeared to rise from 26.5% in 1999–2000 to 34.5% in 2017–2020, adjusted analyses did not indicate a statistically significant trend. In weighted, adjusted analysis, race, age, and socioeconomic status (evaluated via family income-to-poverty ratio) were statistically significant measures associated with prevalence of hypertension. Black participants, elderly participants (above age 65), and those with those with FIPR ≤1 showed the highest prevalence rates within their respective groups. Despite the overall increase in rates of hypertension, the adjusted prevalence of undiagnosed hypertension showed a decline, from 7.35% in 1999-2000 to 5.24% in 2022-2023 (p < 0.001).
Conclusions: Hypertension remains a significant, pervasive condition in the United States. While overall prevalence of hypertension has increased, the rise appears to be linked to demographic factors including age, race, and socioeconomic status. Despite the overall increase in prevalence of hypertension, the prevalence of undiagnosed hypertension has declined, potentially suggesting improvement due to public health initiatives across patient education and screening. Targeted policies and interventions to address disparities across race, socioeconomic status, and age may further reduce the overall burden of hypertension and address the existing gaps in care for higher-risk populations.
[1] Booth JN 3rd, Hubbard D, Sakhuja S, Yano Y, Whelton PK, Wright JT Jr, Shimbo D, Muntner P. Proportion of US Adults Recommended Out-of-Clinic Blood Pressure Monitoring According to the 2017 Hypertension Clinical Practice Guidelines. Hypertension. 2019 Aug;74(2):399-406. doi: 10.1161/HYPERTENSIONAHA.119.12775. Epub 2019 Jun 24. PMID: 31230550; PMCID: PMC6675457.
[2] Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA. 2010 May 26;303(20):2043-50. doi: 10.1001/jama.2010.650. PMID: 20501926.
[3] Lopes AA. Hypertension in black people: pathophysiology and therapeutic aspects. J Hum Hypertens. 2002 Mar;16 Suppl 1:S11-2. doi: 10.1038/sj.jhh.1001333. PMID: 11986885.
Faculty Advisor/Mentor
Rehan Qayyum
Presentation Type
Event
Disciplines
Medical Sciences
85 - Hypertension prevalence time trends in the US population: examination of NHANES 1999 – 2023
Background: Hypertension is a modifiable risk factor for cardiovascular disease and a significant contributor to morbidity and mortality worldwide. In the United States, estimates from the National Health and Nutrition Examination Survey (NHANES) and American Heart Association (AHA) suggest that 103.8 million, or 45% of American adults, may meet the clinical criteria for hypertension, posing a substantial public health challenge[1]. Over the past two decades, significant efforts have been made in screening, educating, and treating patients for high blood pressure, yet the effectiveness of these efforts may vary across demographic and socioeconomic groups[2] [3].
Methods: This study used data from 75,070 participants in the National Health and Nutrition Examination Survey (NHANES), spanning 1999–2023. Hypertension was defined as systolic blood pressure (BP) ≥140 mmHg, diastolic BP ≥90 mmHg, or current antihypertensive medication use. Participants with BP in the hypertensive range but without treatment or prior diagnosis of hypertension were categorized as having undiagnosed hypertension. Model adjustments included age, gender, race/ethnicity, family income-to-poverty ratio (FIPR), and survey cycle.
Results: The overall prevalence of hypertension was 30.7% (95% CI: 30.0–31.5). Although the unadjusted prevalence appeared to rise from 26.5% in 1999–2000 to 34.5% in 2017–2020, adjusted analyses did not indicate a statistically significant trend. In weighted, adjusted analysis, race, age, and socioeconomic status (evaluated via family income-to-poverty ratio) were statistically significant measures associated with prevalence of hypertension. Black participants, elderly participants (above age 65), and those with those with FIPR ≤1 showed the highest prevalence rates within their respective groups. Despite the overall increase in rates of hypertension, the adjusted prevalence of undiagnosed hypertension showed a decline, from 7.35% in 1999-2000 to 5.24% in 2022-2023 (p < 0.001).
Conclusions: Hypertension remains a significant, pervasive condition in the United States. While overall prevalence of hypertension has increased, the rise appears to be linked to demographic factors including age, race, and socioeconomic status. Despite the overall increase in prevalence of hypertension, the prevalence of undiagnosed hypertension has declined, potentially suggesting improvement due to public health initiatives across patient education and screening. Targeted policies and interventions to address disparities across race, socioeconomic status, and age may further reduce the overall burden of hypertension and address the existing gaps in care for higher-risk populations.
[1] Booth JN 3rd, Hubbard D, Sakhuja S, Yano Y, Whelton PK, Wright JT Jr, Shimbo D, Muntner P. Proportion of US Adults Recommended Out-of-Clinic Blood Pressure Monitoring According to the 2017 Hypertension Clinical Practice Guidelines. Hypertension. 2019 Aug;74(2):399-406. doi: 10.1161/HYPERTENSIONAHA.119.12775. Epub 2019 Jun 24. PMID: 31230550; PMCID: PMC6675457.
[2] Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA. 2010 May 26;303(20):2043-50. doi: 10.1001/jama.2010.650. PMID: 20501926.
[3] Lopes AA. Hypertension in black people: pathophysiology and therapeutic aspects. J Hum Hypertens. 2002 Mar;16 Suppl 1:S11-2. doi: 10.1038/sj.jhh.1001333. PMID: 11986885.