Nearly One-Third of US Adults Report Hypertension, Show CDC Data

Approximately 1 in 3 adults in the US reports having hypertension, suggest recent CDC data, which also show that 60% of adults in whom the disorder is diagnosed are using medication for their hypertension.

In the latest Morbidity and Mortality Weekly Report, researchers have published their findings based on survey data from 2017 to 2021, finding that although hypertension prevalence remained unchanged throughout the period, use of antihypertensive medication slightly increased.

“These findings can be used to increase awareness of hypertension and promote lifestyle modifications and antihypertensive medication use to optimize blood pressure control and reduce disparities in prevalence and control,” wrote the researchers of their findings. “Knowledge of trends in diagnosed hypertension and treatment is an essential tool for guiding state-level, individual, clinical, and public health policies and interventions, such as those promoted by the Million Hearts national initiative, to prevent cardiovascular disease.”

Data throughout the study period showed sex-, age-, and race-related differences in hypertension prevalence, and data from 2021 show that hypertension was more common in the following populations:

• Men (33.2%) than women (27%)
• Adults 65 years or older (60.6%) than those aged 18 to 44 years (14.5%)
• Black adults (40.2%) than Asian adults (22.7%)

In this MMWR, data show Black adults were more likely to have hypertension vs Asian adults | Image credit: Prostock-studio - stock.adobe.com

Geographic differences were also observed, with prevalence generally higher among patients in southeastern and Appalachian states and lower in western states.

Throughout the 5-year period, the prevalence of hypertension remained around 30%. Each year of collection included data from approximately 400,000 adults throughout the country. Because the prevalence of hypertension was self-reported, the researchers noted that hypertension prevalence was likely underestimated.

Notably, the lower threshold for hypertension endorsed by the 2017 Guideline for High Blood Pressure in Adults suggests that half of patients aged 18 years or older would have had hypertension between 2017 and 2020. The 2017 guidelines recommended lowering the threshold of hypertension from 140 mm Hg or lower to 130 mm Hg or lower for systolic pressure and from 90 mm Hg or lower to 80 mm Hg or lower for diastolic pressure.

“Several reasons could account for this finding. First, broad implementation of changes to clinical guidelines takes time, and differing guidelines that use higher thresholds (140/90 mm Hg) might attenuate any changes in diagnosed hypertension prevalence,” described the researchers. “Second, some clinical performance measures, which serve as tools to advance the translation of guidelines into clinical practice, were not modified to align with the lower thresholds. For example, the threshold for adequately controlled blood pressure for various insured populations used by one organization remains at the higher threshold of 140/90 mm Hg.”

The group also acknowledged the potential impact of the COVID-19 pandemic, which occurred midway throughout their study period and may have resulted in fewer health care visits. Relying on the 2017 guidelines also suggests an anticipated increase in the number of US adults needing to start or increase antihypertensive medication. The CDC data showed that, after decreasing in use prior to 2017, use of antihypertensive medication began to increase, rising from 59.8% in 2017 to 62.9% in 2021. This increase was observed both overall and across most patient subgroups and various states. Women, adults aged 65 or older, and Black adults were more likely to use medication.

Similar to the trends seen with hypertension prevalence, use of medication for hypertension was higher among patients in southeastern and Appalachian states and lower in western states.

Reference

Sekkarie A, Fang J, Hayes D, Loustalot F. Prevalence of self-reported hypertension and antihypertensive medication use among adults—United States, 2017–2021. MMWR Morb Mortal Wkly Rep. 2024;73(9):191-198. doi:10.15585/mmwr.mm7309a1