Epidemiology

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] 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][10] The prevalence in many developing countries, particularly urban societies, is already as high as those seen in developed countries.[11] 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]

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][14] 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] 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][14] 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]

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