Epidemiology

According to a global analysis of trends in hypertension, the number of adults aged 30-79 years with hypertension increased from 650 million to 1.28 billion in the period 1990-2019.[5] The study also suggested that 53% of women and 62% of men with hypertension were not receiving antihypertensive treatment and that blood pressure (BP) was controlled (receiving antihypertensive medication and BP <140/90 mmHg) in fewer than 1 in 4 women and 1 in 5 men with hypertension.[5] The rate of hypertension has decreased in high-income countries, which now have some of the lowest rates, but has increased in many low- or middle-income countries. 

In the US, surveillance definitions vary widely. Using National Health and Nutrition Examination Surveys (NHANES) data from 2017 to 2020, the American Heart Association (AHA) estimates that the age-adjusted prevalence of hypertension (defined as self-reported use of antihypertensive medication, systolic BP ≥130 mmHg, or diastolic BP ≥80 mmHg) among US adults ≥20 years of age is 46.7%, which equates to 122.4 million adults (age ≥20 years) with high BP in the US.[6]​​ Prevalence increases with age: using NHANES 2017 to 2020 data it was 28.5% among 20- to 44-year-olds, 58.6% among those 45-64 years, and 76.5% among those 65 years of age and over.[6]​ Prevalence is highest in non-Hispanic black men (57.5%) and non-Hispanic black women (58.4%).[6]​ 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.[2][6]​​​​​​​​ The lifetime risk is 90% for men and women who were normotensive at 55 years of age and survive to 80 years.[7]​ Studies using data from NHANES have shown that the decline in BP control from 2013-2014 to 2017-2020 (54.1% to 48.3%) did not continue through 2021-2023 with control increasing to 51.1%.[8][9]​​

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.[10]

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