Blood Pressure (BP) Control
bp_control.RmdFor people with hypertension, controlling their blood pressure can substantially reduce their risk for a heart attack or stroke among many other outcomes.
BP control in the overall US population
The proportion of US adults with hypertension that has controlled blood pressure increased from 1999-2000 to 2013-2014 but has declined recently. Only 21.7% of US adults with hypertension had controlled blood pressure in 2017-2020.
BP control by gender
The proportion of US adults with hypertension that has controlled BP is low among women and men.
BP control by age group
Among all US adults with hypertension, BP control is more likely among older versus young adults. This likely is occurring because many young adults with hypertension are not taking antihypertensive medication.
BP control by race/ethnicity
Non-Hispanic White adults with hypertension are more likely to have controlled BP compared with non-Hispanic Black and Asian and Hispanic US adults.
BP control definition
For this analysis, our definition of BP control was:
Systolic and diastolic BP controlled to the levels recommended in the 2017 ACC/AHA BP guideline, systolic BP < 130 mm Hg and diastolic BP < 80 mm Hg except for those >= 65 years of age without diabetes, chronic kidney disease, history of cardiovascular disease or 10-year predicted ASCVD risk >= 10% estimated using the Pooled Cohort risk equations. For this group, BP control was defined as systolic BP < 130 mm Hg
Who is included in this analysis
There were 107,622 NHANES 1999-2000 to 2017-March 2020 participants. We restricted the the dataset to adults >=18 years of age. This exclusion was applied because statistics for BP levels and hypertension in children and adolescents are markedly different than for adults. We further restricted the population to participants who completed the in-home interview and study examination, with one or more SBP and DBP measurement, and who had data on self-reported antihypertensive medication use. To analyze BP control, we restricted the sample to non-pregnant adults with hypertension, which was defined as:
Hypertension defined by the 2017 ACC/AHA BP guideline, systolic BP >= 130 mm Hg, diastolic BP >= 80 mm Hg or self-reported antihypertensive medication use.
After these exclusions, a total of 26,766 participants were included for the current analysis.
| Inclusion | Overall | 1999-2000 | 2001-2002 | 2003-2004 | 2005-2006 | 2007-2008 | 2009-2010 | 2011-2012 | 2013-2014 | 2015-2016 | 2017-2020 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Participants | 107622 | 9965 | 11039 | 10122 | 10348 | 10149 | 10537 | 9756 | 10175 | 9971 | 15560 |
| >=18 years old | 63041 | 5448 | 5993 | 5620 | 5563 | 6228 | 6527 | 5864 | 6113 | 5992 | 9693 |
| Completed interview and examination | 59799 | 4976 | 5592 | 5303 | 5334 | 5995 | 6360 | 5615 | 5924 | 5735 | 8965 |
| Had SBP and DBP measurements | 56286 | 4755 | 5251 | 4902 | 5028 | 5670 | 6053 | 5436 | 5700 | 5557 | 8024 |
| Had self-reported information on antihypertensive medication | 56035 | 4694 | 5184 | 4838 | 5015 | 5665 | 6043 | 5337 | 5694 | 5552 | 8013 |
| Not pregnant | 54084 | 4369 | 4822 | 4550 | 4633 | 5590 | 5945 | 5248 | 5588 | 5444 | 7895 |
| With hypertension | 26757 | 2238 | 2389 | 2237 | 2116 | 2788 | 2865 | 2575 | 2608 | 2733 | 4208 |
Age adjustment
For age adjustment in this analysis, we set the age distribution for the standard population to represent US adults with hypertension from 1999 to 2020: 26.4%, 43.5%, 17%, and 13.2% being 18 to 44, 45 to 64, 65 to 74, and 75+ years of age, respectively
Make your own results
You can find the online application where customized graphs can be made here: https://bcjaeger.shinyapps.io/nhanesShinyBP/