Number of Americans With High Blood Pressure Rose in Last Decade

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The number of adults in the United States with high blood pressure increased by 30 percent between 1988 and 2000, according to a study that analyzed government health statistics and other data gathered nationwide during the period.

The study found that at least 65 million Americans have hypertension, defined as blood pressure of 140/90 millimeters of mercury (mm Hg) or higher, using blood-pressure-lowering medications, or having been told at least twice by a physician or other health professional that they had high blood pressure. By that definition, almost a third of U.S. adults have hypertension.

"The bottom line is that the estimated number of adults with high blood pressure has increased," says Larry E. Fields, M.D., lead author of the study and senior executive advisor to the assistant secretary of the Department of Health and Human Services.

"High blood pressure is a major risk factor for coronary heart disease, kidney failure, heart failure, stroke, and other conditions. From a public and health professional perspective. it is important to be aware of high blood pressure, to have blood pressure checked regularly, and, if blood pressure is elevated, to initiate appropriate counseling and treatment," he says.

The findings came from an analysis of data from the U.S. Census Bureau and the 1999-2000 National Health and Nutrition Examination Survey (NHANES) IV, which included 4,531 people. The study was limited to people at least 18 years old. The new estimate is much higher than the previous NHANES report, based on data gathered between 1988 and 1994, which estimated that at least 50 million U.S. adults had high blood pressure.

Blood pressure values were based on three measurements that a physician took during a single visit to a mobile examination center.

Fields and his associates estimated that 59.2 million people had hypertension on the basis of blood pressure measurements or prescriptions for blood pressure medication. More than 6 million people had high blood pressure based on their medical history, resulting in an estimated total of 65.2 million hypertensive adults.

The 1999-2000 survey shows that 28.7 percent of women and 28.3 percent of men have high blood pressure. When prevalence was divided along racial and ethnic categories, non-Hispanic black Americans have the highest prevalence at 38.8 percent. High blood pressure is prevalent in 28.7 percent of the Mexican-American population, and in 27.2 percent of the non-Hispanic white population.

The study, published in the Aug. 24, 2004, issue of Hypertension, did not specifically examine potential reasons for the increased prevalence of high blood pressure. However, the investigators cited the aging of the U.S. population and the growing proportion of overweight and obese Americans as potential major contributors.

"It has been demonstrated that interventions that center on health behavior, such as getting regular physical activity, controlling weight, and eating a nutritious diet that includes lots of fruits and vegetables and moderate amounts of salt, can reduce a person's chances of developing high blood pressure," says Fields.

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