According to the World Health Organization, an estimated 1.13 billion people have hypertension worldwide (defined as systolic blood pressure [BP] ≥140 mmHg and diastolic BP ≥90 mmHg) with most living in low- and middle-income countries.[8]World Health Organization. Hypertension. Sep 2019 [internet publication].
https://www.who.int/news-room/fact-sheets/detail/hypertension
It is becoming an increasingly common problem because of increased longevity and the prevalence of contributing factors such as obesity, physical inactivity, and unhealthy diet.[9]Singh RB, Suh IL, Singh VP, et al. Hypertension and stroke in Asia: prevalence, control and strategies in developing countries for prevention. J Hum Hypertens. 2000 Oct-Nov;14(10-11):749-63.
https://www.nature.com/articles/1001057
http://www.ncbi.nlm.nih.gov/pubmed/11095165?tool=bestpractice.com
[10]Yusuf S, Reddy S, Ôunpuu S, et al. Global burden of cardiovascular diseases. Part I: General considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001 Dec 4;104(22):2746-53.
https://www.ahajournals.org/doi/10.1161/hc4601.099487
http://www.ncbi.nlm.nih.gov/pubmed/11723030?tool=bestpractice.com
The prevalence in many developing countries, particularly urban societies, is already as high as those seen in developed countries.[11]Khor GL. Cardiovascular epidemiology in the Asia-Pacific region. Asia Pac J Clin Nutr. 2001;10(2):76-80.
http://www.ncbi.nlm.nih.gov/pubmed/11710361?tool=bestpractice.com
In England, the prevalence of high blood pressure in 2015 was reported as 31% among men and 26% among women, affecting more than 1 in 4 adults.[12]Public Health England. Health matters: combating high blood pressure. Jan 2017 [internet publication].
https://www.gov.uk/government/publications/health-matters-combating-high-blood-pressure/health-matters-combating-high-blood-pressure
In the US, surveillance definitions vary widely. Using National Health and Nutrition Examination Surveys (NHANES) data from 2011 to 2014 and BP thresholds from the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline, the prevalence of hypertension among US adults was estimated to be 46.0%; using BP thresholds from the 7th Joint National Committee (JNC 7) guideline, the prevalence was estimated at 31.9%.[13]Muntner P, Carey RM, Gidding S, et al. Potential US population impact of the 2017 ACC/AHA high blood pressure guideline. J Am Coll Cardiol. 2018 Jan 16;71(2):109-18.
https://www.jacc.org/doi/full/10.1016/j.jacc.2017.10.073
http://www.ncbi.nlm.nih.gov/pubmed/29146532?tool=bestpractice.com
[14]Virani SS, Alonso A, Benjamin EJ, et al. Heart disease and stroke statistics - 2020 update: a report from the American Heart Association. Circulation. 2020 Mar 3;141(9):e139-596.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000000757
http://www.ncbi.nlm.nih.gov/pubmed/31992061?tool=bestpractice.com
Using NHANES data from 2013 to 2016, the AHA reports that there are an estimated 116.4 million adults (age ≥20 years) with high BP in the US.[14]Virani SS, Alonso A, Benjamin EJ, et al. Heart disease and stroke statistics - 2020 update: a report from the American Heart Association. Circulation. 2020 Mar 3;141(9):e139-596.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000000757
http://www.ncbi.nlm.nih.gov/pubmed/31992061?tool=bestpractice.com
Prevalence is highest in non-Hispanic black males (58.6%) and non-Hispanic black females (56.0%). The incidence increases with age in people of all ancestries and both sexes. Prevalence is higher in men than in women before 65 years of age, and higher in women than in men from 65 years of age.[5]Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018 May 15;71(19):e127-248.
https://www.jacc.org/doi/full/10.1016/j.jacc.2017.11.006
http://www.ncbi.nlm.nih.gov/pubmed/29146535?tool=bestpractice.com
[14]Virani SS, Alonso A, Benjamin EJ, et al. Heart disease and stroke statistics - 2020 update: a report from the American Heart Association. Circulation. 2020 Mar 3;141(9):e139-596.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000000757
http://www.ncbi.nlm.nih.gov/pubmed/31992061?tool=bestpractice.com
AHA Centers for Health Metrics and Evaluation: 2017 hypertension guidelines visualisation
external link opens in a new window The lifetime risk is 90% for men and women who were normotensive at 55 years of age and survive to 80 years.[15]Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hypertension in middle-aged women and men: the Framingham Heart Study. JAMA. 2002 Feb 27;287(8):1003-10.
https://jamanetwork.com/journals/jama/fullarticle/194679
http://www.ncbi.nlm.nih.gov/pubmed/11866648?tool=bestpractice.com