Hypertension Prevalence and Control Among Adults: United States, 2015-2016

Questions for Cheryl Fryar, M.S.P.H., Health Statistician and Lead Author on “Hypertension Prevalence and Control Among Adults: United States, 2015-2016”

Q: What made you decide to conduct this study on hypertension prevalence and control?

CF: The primary motivation for conducting this study was to offer the public updated data on U.S. adults who have high blood pressure. Every two years new data are available for us to provide updated estimates of hypertension prevalence and control. Data were recently released for the 2015-2016 National Health and Nutrition Examination Survey, and our next step was to analyze the data and provide accessible statistical information that might guide actions to improve the health of the American people.

Q: Was there a finding in your new study that surprised you, and if so, why?

CF: The findings were pretty consistent with what’s been previously reported. The prevalence of hypertension hasn’t changed much since 1999. Among those with hypertension, controlled hypertension increased between 1999 and 2010, and then has remained stable since that time. There was an observed decrease in hypertension control since 2013-2014, but this change was not statistically significant. It is too early to tell whether or not a change in hypertension control is occurring.

Q: What do you think is the most interesting demographic finding among your new study’s findings for 2015-2016 – age, race, sex?

CF: There are a number of interesting demographic findings in this report, and we still find disparities among demographic subgroups. Hypertension prevalence was highest among non-Hispanic black men and women. Hypertension also increases with age — from 7.5% in the youngest age group 18-39, to 63.1% in the oldest age group 60 and over.

On the other hand, among adults with hypertension, about half of adults 40 and over with hypertension had controlled hypertension compared to about a third of young adults. Overall, women with hypertension had higher controlled hypertension than men with hypertension.

Q: When you identified adults with controlled hypertension in your study, was that through participants’ self-reporting that they were on medication for high blood pressure or another method? If it was self-reporting, how do you know it’s true?

CF: One of the strengths of the National Health and Nutrition Examination Survey, or NHANES, is that it combines both interviews in the home and physical examinations in mobile examination centers, including blood pressure measurement. In order to identify people with controlled hypertension, we looked at the measured blood pressure of adults who were taking medication for their hypertension. If they had a measured systolic blood pressure reading < than 140 mmHg AND a diastolic reading of <90 mmHg, then their hypertension was considered controlled.

Q: What is the take-home message from this report? 

CF: I think the take-home message of this report is that hypertension prevalence has remained unchanged since 1999 at around 29%, and that just under half of adults with hypertension have their hypertension under control. High blood pressure among U.S. adults is a persistent and prevalent concern that is a serious factor in the health and well-being of the nation. The statistics in this new report show that we have yet to meet the Heathy People 2020 Goal of 61.2% for hypertension control.