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]NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021 Sep 11;398(10304):957-80.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01330-1/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/34450083?tool=bestpractice.com
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]NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021 Sep 11;398(10304):957-80.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01330-1/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/34450083?tool=bestpractice.com
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]Martin SS, Aday AW, Almarzooq ZI, et al. 2024 heart disease and stroke statistics: a report of US and global data from the American Heart Association. Circulation. 2024 Feb 20;149(8):e347-913.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001209
http://www.ncbi.nlm.nih.gov/pubmed/38264914?tool=bestpractice.com
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]Martin SS, Aday AW, Almarzooq ZI, et al. 2024 heart disease and stroke statistics: a report of US and global data from the American Heart Association. Circulation. 2024 Feb 20;149(8):e347-913.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001209
http://www.ncbi.nlm.nih.gov/pubmed/38264914?tool=bestpractice.com
Prevalence is highest in non-Hispanic black men (57.5%) and non-Hispanic black women (58.4%).[6]Martin SS, Aday AW, Almarzooq ZI, et al. 2024 heart disease and stroke statistics: a report of US and global data from the American Heart Association. Circulation. 2024 Feb 20;149(8):e347-913.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001209
http://www.ncbi.nlm.nih.gov/pubmed/38264914?tool=bestpractice.com
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]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
[6]Martin SS, Aday AW, Almarzooq ZI, et al. 2024 heart disease and stroke statistics: a report of US and global data from the American Heart Association. Circulation. 2024 Feb 20;149(8):e347-913.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001209
http://www.ncbi.nlm.nih.gov/pubmed/38264914?tool=bestpractice.com
The lifetime risk is 90% for men and women who were normotensive at 55 years of age and survive to 80 years.[7]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
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]Abdalla M, Bolen SD, Brettler J, et al. Implementation strategies to improve blood pressure control in the United States: a scientific statement from the American Heart Association and American Medical Association. Hypertension. 2023 Oct;80(10):e143-57.
https://www.ahajournals.org/doi/10.1161/HYP.0000000000000232
http://www.ncbi.nlm.nih.gov/pubmed/37650292?tool=bestpractice.com
[9]Hardy ST, Jaeger BC, Foti K, et al. Trends in blood pressure control in US adults with hypertension, 2013-2014 to 2021-2023. Am J Hypertens. 2024 Nov 6:hpae141.
https://academic.oup.com/ajh/advance-article/doi/10.1093/ajh/hpae141/7879521
http://www.ncbi.nlm.nih.gov/pubmed/39504487?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.[10]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