NCHS Data Brief ■ No. 48 ■ October 2010

u.s. department of health and human services

Centers for Disease Control and Preven

National Center for Health Statis

Recent Trends in the Prevalence of High Blood Pressure 

and its Treatment and Control, 1999–2008

Sung Sug (Sarah) Yoon, Yechiam Ostchega, and Tatiana 

Key findings 

Data from the National 

Health and Nutrition 

Examination Survey

• There was no significant 

change in the prevalence of 

high blood pressure among 

U.S. adults from 1999–2000 

to 2007–2008. This was true 

for men and women, all age 

groups, and for non-Hispanic 

white, non-Hispanic black, 

and Mexican-American adults.

• Among U.S. adults with 

high blood pressure, the 

percentage that was aware of 

the condition increased from 

69.6% in 1999–2000 to 80.6% 

in 2007–2008. 

• Among U.S. adults with 

high blood pressure, the 

percentage who were taking 

medication to lower their 

blood pressure increased 

from 1999–2000 through 

2007–2008. 

• The control of blood 

pressure increased among 

U.S. adults with high blood 

pressure from 1999–2000 

through 2007–2008. Increases 

in control occurred for all 

subgroups of the population.

High blood pressure is one of the most common risk factors for cardiovascular disease and stroke (1). This report evaluates the overall trends in ageadjusted high blood pressure prevalence, awareness, treatment, and control 

using the most recent 10 year NHANES data. It also examines these ageadjusted rates for hypertension by sex, age, and race and ethnicity.

Keywords: high blood pressure • prevalence • trends

What is the recent trend in the prevalence of high blood 

pressure among U.S. adults and are there differences in 

trends among racial or ethnic groups?

• The prevalence of high blood pressure did not significantly change over 

the 10-year period 1999–2008; it remained approximately 30% 

(Figure 1). 

• The prevalence of high blood pressure did not change significantly 

for non-Hispanic white, non-Hispanic black, or Mexican-American 

adults over the 10-year period. The prevalence of high blood pressure 

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NCHS Data Brief ■ No. 48 ■ October 2010

■  2  ■

remained higher among non-Hispanic black adults compared with non-Hispanic white and 

Mexican-American adults throughout this time period. 

• The prevalence of high blood pressure did not change among either men or women during 

this period (data not shown). 

Has the prevalence of high blood pressure changed for different age 

groups? 

• During 1999–2008, there was no significant change in the prevalence of high blood pressure 

among adults aged 18–39, 40–59, or 60 years and older (Figure 2). 

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NCHS Data Brief ■ No. 48 ■ October 2010

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Among adults with high blood pressure, has there been any change in the 

proportion who are aware of their condition? 

• Among adults with high blood pressure, the overall percentage of adults who were aware 

of the problem increased from 69.6% in 1999–2000 to 80.6% in 2007–2008. The trend in 

awareness of high blood pressure was similar for men and women (data not shown) 

(Figure 3).

• The percentage of adults who were aware of their high blood pressure increased over the 

10-year period for hypertensive adults aged 40–59 years and 60 years and older, but not for 

those aged 18–39 years. 

• Awareness increased among non-Hispanic white and non-Hispanic black adults, but not 

Mexican-American adults over the 10-year period, 1999–2000 through 2007–2008.

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NCHS Data Brief ■ No. 48 ■ October 2010

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Among adults with high blood pressure, what is the trend in the proportion 

who are treated with medication?

•	 Among	persons	with	high	blood	pressure,	the	percentage	who	were	treated	with	medication	

increased	from	59.4%	in	1999–2000	to	71.6%	in	2007–2008.	The	increase	occurred	for	

both	men	and	women	(data	not	shown),	the	non-Hispanic	white,	non-Hispanic	black,	and	

Mexican-American	populations	(Figure	4).

•	 Among	adults	who	had	high	blood	pressure,	the	percentage	who	was	taking	medication	to	

lower	their	blood	pressure	increased	for	those	aged	18–39	years	and	aged	60	years	and	older	

but	not	for	those	aged	40–59	years.	











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NCHS Data Brief ■ No. 48 ■ October 2010

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Among adults with high blood pressure, what is the trend in the proportion 

of adults who have controlled blood pressure?

•	 Among	adults	with	high	blood	pressure,	the	overall	percentage	of	adults	who	have	

controlled	blood	pressure	increased	from	31.6%	in	1999–2000	to	48.4%	in	2007–2008	

(Figure	5).

•	 There	was	a	significant	increase	in	the	percentage	of	hypertensive	adults	who	achieved	

blood	pressure	control	for	both	men	and	women	(data	not	shown),	all	age	groups	(18–39	

years,	40–59	years,	and	60	years	and	older),	and	all	three	major	race	and	ethnic	groups	(nonHispanic	white,	non-Hispanic	black,	and	Mexican	American)	over	the	10-year	period.	









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NCHS Data Brief ■ No. 48 ■ October 2010

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Summary

Overall, the prevalence of high blood pressure among U.S. adults did not change over the last 

decade (1999–2008). However, there have been significant increases in high blood pressure 

awareness, treatment, and control among persons with high blood pressure over this same time 

period. 

More detailed analyses showed that trends among population subgroups were consistent with the 

trends in the overall population, with few exceptions. The lack of change in the prevalence of 

high blood pressure from 1999–2000 through 2007–2008 was consistent among all population 

subgroups defined by sex, age, and race and ethnicity. Among adults with high blood pressure, 

there were increasing trends in the proportion who were aware of their condition among most 

demographic subgroups; the exceptions were those aged 18–39 years and Mexican-American 

adults. The percentage who were treated with medication to control their blood pressure 

increased from 1999–2000 through 2007–2008 for all groups except those aged 40–59 years. The 

percentage whose blood pressure was controlled increased among all population subgroups over 

this time period. 

Definitions

High blood pressure: Systolic blood pressure greater than or equal to 140 mm Hg or diastolic 

blood pressure greater than or equal to 90 mm Hg or currently taking medication to lower high 

blood pressure (2,3). 

The average of up to three brachial systolic and diastolic blood pressure readings was used for 

systolic and diastolic BP values. All BP readings were obtained at a single examination visit. 

BP was measured in a mobile examination center by trained physicians following a standard 

protocol. Appropriate BP cuff sizes were used for participants based on measurement of mid-arm 

circumference. Estimates are age-adjusted.

Awareness of high blood pressure: Defined by an affirmative response to the question “Have you 

ever been told by a doctor or health professional that you had hypertension, also called high blood 

pressure?” Estimates are age-adjusted.

Currently taking medication to lower BP: Among all adults who had high blood pressure, defined 

by affirmative responses to the following questions: “Because of your high blood pressure/

hypertension, have you ever been told to take prescribed medicine?” and “Are you now following 

this advice to take prescribed medicine?” Estimates are age-adjusted.

Controlled high blood pressure: Systolic BP less than 140 mm Hg and diastolic BP less than 90 

mm Hg among those with high blood pressure (4,5). Estimates are age-adjusted. 

Data sources and methods

The National Health and Nutrition Examination Surveys (NHANES) were used for these 

analyses. NHANES is designed to monitor the health and nutritional status of the civilian, 

noninstitutionalized U.S. population (4). The survey consists of interviews conducted in 

participants’ homes, standardized physical examinations conducted in specially outfitted mobile 

examination centers, and laboratory tests utilizing blood and urine specimens provided by 

participants during the physical examination. 
NCHS Data Brief ■ No. 48 ■ October 2010

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The NHANES sample is selected through a complex, multistage design that includes selection of 

primary sampling units (counties), household segments within the counties, and finally sample 

study participants from selected households. The sample design includes oversampling to obtain 

reliable estimates of health and nutritional measures for population subgroups. In 1999–2006, 

non-Hispanic black persons, Mexican-American persons, persons with low-income, persons 

aged 12–19 years, and persons 60 years and over were over sampled to obtain reliable prevalence 

estimates for these specific population subgroups. In 1999, NHANES became a continuous 

survey, fielded on an ongoing basis. Each year of data collection is based on a representative 

sample covering all ages of the civilian, noninstitutionalized population. Public-use data files 

are released in 2-year cycles. Sample weights, which account for the differential probabilities 

of selection, nonresponse, and noncoverage, are incorporated into the estimation process. The 

standard errors of the percentages were estimated using Taylor series linearization, a method that 

incorporates the sample weights and sample design. 

Age-adjusted prevalence estimates were calculated for race and ethnicity and sex categories 

using SUDAAN proc descript and using the 2000 projected U.S. population (using the 2000 

U.S. Census age groups of 18–39 years, 40–59 years, and 60 years and older) (5). Age-adjusted 

prevalence of awareness of high blood pressure, treatment of high blood pressure, and control 

rates of high blood pressure were calculated using the subpopulation of persons who have high 

blood pressure. To test for linear and quadratic trends in survey periods, the null hypothesis of 

nonlinear or quadratic trend were examined using orthogonal polynomials (6). All significance 

tests were two-sided using p<0.05 as the level of statistical significance. All differences reported 

are statistically significant unless otherwise indicated. Statistical analyses were conducted using 

the SAS System for Windows (release 9.1; SAS Institute Inc, Cary, N.C.) and SUDAAN (release 

9.0; Research Triangle Institute, Research Triangle Park, N.C.). 

About the authors

Sung Sug (Sarah) Yoon, Yechiam Ostchega, and Tatiana Louis are with the Centers for Disease 

Control and Prevention’s National Center for Health Statistics, Division of Health and Nutrition 

Examination Surveys.

References

1. Whitworth JA, World Health Organization, International Society of Hypertension Writing 

Group. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) 

statement on management of hypertension. J Hypertens 21:1983–92. 2003.

2. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The Seventh 

report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of 

High Blood Pressure: the JNC 7 report. JAMA 289(19):2560–72. 2003. 

3. National Heart Lung and Blood Institute. National High Blood Pressure Education Program. 

Available from: http://www.nhlbi.nih.gov/about/nhbpep/nhbp_pd.htm.

4. The National Health and Nutrition Examination Survey (NHANES) Examination Manuals 

(1999–2000; 2001–2002; 2003–2004; 2005–2006). Hyattsville, MD: National Center for Health 

Statistics. http://www.cdc.gov/nchs/nhanes/nhanes1999-2000/nhanes99_00.htm. Accessed 

October 27, 2009.
NCHS Data Brief ■ No. 48 ■ October 2010

5. Klein RJ, Schoenborn C. Age adjustment using the 2000 projected 

U.S. population. Healthy People Statistical Notes, no 20. Hyattsville, MD: 

National Center for Health Statistics. 2001.

6. Winer BJ. Statistical principles in experimental design. New York, NY: 

McGraw-Hill companies; 878 (Table C.10). 1971.

Suggested citation

Yoon S, Ostchega Y, Louis T. Recent trends 

in the prevalence of high blood pressure and 

its treatment and control, 1999–2008. NCHS 

data brief, no 48. Hyattsville, MD: National 

Center for Health Statistics. 2010.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Associate 

 Director for Science

Division of Health and Nutrition 

Examination Surveys

Clifford L. Johnson, M.S.P.H., Director

U.S. De

Health 

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, MD 20782

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