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Age-stratified prevalence, treatment status, and associated factors of hypertension among US adults following application of the 2017 ACC/AHA guideline

Hypertension Research volume 42, pages 1631–1643 (2019)Cite this article

Abstract

The 2017 American College of Cardiology/American Heart Association Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults reduced the systolic/diastolic blood pressure thresholds to define hypertension, including recommendations about treatment initiations and goals. We estimated the age-stratified prevalence, treatment status, and factors associated with hypertension among US adults aged ≥ 20 years based on this guideline. This cross-sectional study used the 2011–2016 National Health and Nutrition Examination Survey data. The primary outcomes were the presence and treatment status of hypertension. Among 16,103 participants, the proportions (95% confidence interval) of hypertensive, treatment-indicated, untreated individuals among treatment-indicated, and treatment goals not met among treated for hypertension by age groups were, respectively, 17.4% (15.8–19.1), 6.9% (6.1–7.8), 67.6% (61.0–73.5), and 58.6% (46.1–70.2) among 20–34 years; 39.2% (37.0–41.5), 24.4% (22.4–26.5), 41.8% (37.7–46.0), and 50.4% (44.7–56.1) among 35–49 years; 62.3% (60.1–64.6), 51.4% (49.0–53.8), 31.0% (28.2–34.0), and 51.9% (47.6–56.1) among 50–64 years; 77.7% (75.3–79.8), 77.0% (74.7–79.2), 27.0% (24.3–29.8), and 63.1% (59.4–66.5) among ≥ 65 years; and 46.8% (45.4–48.3), 36.9% (35.4–38.5), 33.2% (30.9–35.5), and 56.7% (54.1–59.3) among overall population. Despite some dissimilarities, the prevalence, treatment eligibility, and odds of hypertension were higher among non-Hispanic blacks and among people with high cholesterol, low high-density lipoprotein, chronic kidney disease, diabetes, increased body weight, and low leisure-time physical activity in all age strata. The prevalence and treatment eligibility were high among adults from all age groups; however, a significant proportion of participants, especially those who were younger, had blood pressure levels above the treatment goals or were untreated. Addressing the associated characteristics from a younger age may help prevent the complications of hypertension.

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Fig. 1

Data availability

The datasets are publicly available at the Centers for Disease Control and Prevention’s website. Dr. Kibria has full access to the data and takes responsibility for theintegrity of the data analysis.

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Acknowledgements

The authors are thankful to the survey participants and staff for their relentless efforts to obtain the NHANES data.

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  1. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, 21201, USA

    Gulam Muhammed Al Kibria, Amy Nemirovsky & Brendan Day

  2. School of Community Health and Policy, Morgan State University, Baltimore, MD, 21251, USA

    Atia Sharmeen

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Conceptualization: Gulam Kibria; formal analysis: Gulam Kibria; writing—original draft preparation: Gulam Kibria, Brendan Day, and Atia Sharmeen; writing—review and editing: Amy Nemirovsky and Brendan Day.

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Correspondence to Gulam Muhammed Al Kibria.

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Al Kibria, G.M., Nemirovsky, A., Sharmeen, A. et al. Age-stratified prevalence, treatment status, and associated factors of hypertension among US adults following application of the 2017 ACC/AHA guideline. Hypertens Res 42, 1631–1643 (2019). https://doi.org/10.1038/s41440-019-0275-x

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