v v

& ‘g ~ ~T~ 

FROM VITAL & HEALTH STATISTICS OF THE NATIONAL CENTER FOR HEALTH STATISTICS 

u.S. DEPARTMENT OF HEALTH, EmCATION, AND WELFARE t No. 1 October 18, 1976 I Public Health Serwce. Health Resources Admimstrat!on 

Blood Pressure of Persons 6-74 Years of Age in the 

United Statesa 

@ 

Single blood pressurk- measurements were 

obtained among a national probability sample of 

persons representative of the U.S. civilian noninstitutionalized population 6-74 years of age in 

the Health and Nutrition Examination Survey 

(HANES) from April 1971 through June 1974. 

This first Health and Nutrition Examination 

Survey program, in which these data were 

obtained, was designed to measure the nutritionstatus of the U.S. population as well as certain 

pects of the general health status and medical 

care needs of the U.S. population. This is the 

fourth of the Health Examination Survey programs that obtain information on the prevalence 

of medically defined illness, on unrecognized or 

undiagnosed conditions, and on a variety of 

physical, physiological, and psychological measures within the population through direct examinations, tests, and measurements, as described 

in previous publications. 14 

Blood pressure measurements of the persons 

in this HANES sample were made at 65 preselected locations throughout the country by 

aThis report prepared by Jean Roberts and Kurt 

Maurer, Division of Health Examination Statistics. 

the survey examining physicians using standardized methods based on the 1951 recommendations of the American Heart Association.5 Of 

the 24,513 sample persons selected to represent 

the 131.4 milI.ion persons 6-74 years of age in 

the U.S. population, 17,796 (or 72.6 percent) 

were examined. This corresponds to an effective 

response rate of 74.4 percent when adjustment 

is made for the effect of oversampling among 

the poor, preschool children, women of childbearing age, and the elderly. National estimates 

of the distribution of bIood pressure leveIs, prevalence of hypertension, and related medical 

history among the U.S. population based on 

findings from this HANES program have been 

described and analyzed in the report “Blood 

Pressure Levels of Persons 6-74 Years: United 

States, 1971 -1974,” Vital and Health Statistics, 

Series 11, No. 2036 (in preparation). Selected 

data and findings from that report are incIuded 

here in tabIes 1-6. 

Highlights 

Mean systolic bIood pressure of the U.S. 

population increases with age from 103.3 mm. 

Advance Data j+om Vital and Health Statistics replaces the supplements to the Monthly Vital Statistics 

Re@ort as the means for early release of selected fiidings from the health and demographic surveys conducted by 

the NCHS. Most of these releases will be followed by detailed reports in the Vital and Health Statistics series. 

Provisional vital statistics as well as advance reports of final data for a yem will continue to be published in 

the Monthly Vital Statistics Report. 

Advance Data is being distributed on the mailing keys for the Vital and Health Statistics series, and people 

who now receive reports from a particular series will also receive all Advance Data releases for that series. 

Temporarily, the mfllng list for the Monthly Vital Statistics Report (MVSR) is also being used. MVSR readers 

who wish to continue to receive Advance Data issues, aa well aa other persona who wish to receive all issues, 

should contact: National Center for Health Statistics, Room 8-20, 5600 Fishers Lane, Rockville, Maryland 

20852, Phone: (301) 443-1200. 
2 

Hg among children age 7-11 years to 150.1 mm. 

Hg among the oldest adults in the study, those 

ages 65-74 years. From 12 through 54 years of , 

age the mean levels of systolic pressure among 

males exceed those for females, but from 55 

through 74 years, the mean levels of women are 

the higher. 

Diastolic pressure (mean values) of mzdes increases with age and significantly exceeds mean 

levels of women from 18 through 54 years then 

decreases slowly through 74 years, while among 

women dkstolic pressure levels off at ages 65-74 

years but does not decrease significantly. 

At 25-74 years of age, systolic and diastolic 

mean pressures for Negro men exceed those for 

white men, and those for Negro women exceed 

the mean levels for white women. 

Mean systolic and diastolic blood pressures 

among the population decrease significantly 

with an increase in family income and education. 

While no regionzd differences in mean diastolic blood pressure is evident, mean systolic 

blood pressure of persons living in the South is 

significantly higher for both white and Negro 

men and women than for those living in the 

Northeast or West. 

There were an estimated 23.4 million persons 12-74 years of age, including 23,2 million 

or 18.1 per 100 adults ages 18-74 years, in the 

United States with definite hypertension–that is 

either systolic blood pressure of at least 160 

mm. EIg or diastolic blood pressure of at least 95 

mm. Hg. The prevalence rate of definite hypertension, as defined here, increases rapidly with 

age from 0.8 per 100 at ages 12-17 years to 40.7 

per 100 at ages 65-74 years. At ages 18-54 years, 

definite hypertension is more prevalent among 

men than among women, but at ages 65-74 years 

the condition is more prevalent among women 

than among men. About one-fourth of the 

adults with definite hypertension have diastolic 

blood pressure of at least 105 mm. Hg. 

Hypertension is substantially more prevalent 

among Negro adults than among white adults in 

the United States. 

More than half of the adults with definite 

hypertension have never been told by their doctors that they have ‘this condition or high blood 

pressure. One-fourth of those with definite 

hypertension have been taking medication regularly or occasionally for high blood pressure 

within the preceding 6 months. 

Mean systolic blood pressure levels of U.S. 

children and youths as determined in the present 

1971-74 study are substantially lower and the 

mean diastolic pressures somewhat lower than 

those national estimates for children from the 

Health Examination Survey of 1963-65 and for 

youths from the Health Examination Survey of 

1966-70, apparently because of survey differences that have been analyzed in detail.G 

Among adults 18-74 years, natiomil estimates of mean systolic and diastolic bIood pressure levels from the Health and Nutrition Examination Survey of 1971-74 are in closer agreement with those from the Health Examination 

Survey of 1960-62 than with those for children 

and youths at the two available points in time. 

Mean systolic blood pressure level estimates for 

U.S. adults ages 18-54 years are nearly identical 

from both surveys, but from 55 through 74 

years they are lower by an average of 4-$3 mm. 

Hg in 1971-74 than in 1960-62. The diastolic 

pressure levels from the more recent survey are 

consistently higher (by an average of 3 mm. Hg)-. 

across the &je &ge 18-74 years, -

MEAN SYSTOLIC AND DIASTOLIC BLOOD PRESSURE 

(JF PERSONS 7-74 YEARS BY AGE AND SEX: UNITED 

STATES, 1971-74 

160 

=: ti-::$aa 

{ 1~ Oia$tdk a 

$80- 1 

)-
 60
 LLu_udJ 0 10 20 30 40 60 60 70 60 

AGE IN YEARS AT LAST BIRTHDAY 
TECHNICAL NOTES 

The sampling plan for the 65 examination 

locations in the Health and Nutrition Examination Survey of 1971-74 followed a stratified, 

multistage probability design in which a sample 

of the civilian noninstitutionalized population of 

the conterminous United States 1-74 years of 

age was selected. The sample was stratified by 

geographic region, population density, and rate 

of population change between 1960 and 1970. 

Within each stratum, cluster type sampling was 

used for seiecting households and sample persons to be included in each examination location. The sample design provided for oversampling among persons living in poverty areas, 

preschool age children, and women 20-44 years 

of age. 

The blood pressure level and related data in 

this report are shown as population estimates, 

that is, the examination findings for each individual have been “weighted” by the reciprocal 

of the probability of s=lecting &e perso-n. An 

o 

1National Center for Health Statistics: Plan and initial program of the Health Examination Survey. Vital 

and Health Statistics. PHS Pub. No. 1000-Series l-No. 4. 

Public Health Service. Washington. U.S. Government 

Printing Office, July 1965. 

2National Center for Health Statistics: Plan, operation, and response results of a program of children’s examinations. Vital and Health Statistics. PHS Pub. No. 

1000-Series l-No. 5. Public Health Service. Washington. 

U.S. Government Printing Office, Oct. 1967. 

3National Center for Health Statistics: Plan and operation of a Health Examination Survey of U.S. youths 

12-17 yesrs of age. Vital and Health Statistics. PHS Pub. 

No. 1000-Series l-No. 8. Public Health Service. Washington. U.S. Government Printing Office, Sept. 1969. 

4Natlona tienter for Health Statistics: Plan and 

operation of the Health and Nutrition Examination Suradjustment for persons in the sample who were 

not examined and a poststratified ratio adjustment were also made so that the final sample 

estimates of the population size agree exactly 

with independent U.S. Bureau of Census estimates for the civilian noninstitutionalized population of the United States as of November 1, 

1972, by color, sex, and age. 

The tables in this report contain, for the vari ous statistics presented, estimates of their 

sample variability (standard or sampIing errors 

of the mean) which have been specially derived 

by a pseudoreplication method adapted specifically to the sample design used in the Health and 

Nutrition Examination Survey.7 Data in the 

tables exclude 6-year-olds because no measurements were obtained for about one-fourth of 

this group, and the estimates for them are consequently less reliable than for those 7-74 years of 

age.6 

vey, United States, 197 1-i’ 3. Vital and Health Statistics. 

Series 1-Nos. 10a and 10b. DHEW Pub. No. (HSM) 

73-1310. Washington. U.S. Government Printing Office, 

Feb. 1973. 

5Committee to Revise Standardization of High 

Blood Pressure Readings: Recommendations for human 

blood pressure determinations by sphygmomanqmeters. 

New York. American Heart Association. Oct. 19’51. 

6National Center for Health Statistics: Blood pressure levels of persons 6-74 years of age in the United 

States. Vital and Health Statistics. Series 1l-No. 203. 

DHEW, Rockville, Md. In preparation. 

7National Center for Health Statistics: Replication: 

An approach to the analyses of data from complex surveys. Vital and Health Statistics. PHS Pub. No. 1000-

Series 2-No. 14. Public Health Service. Washington. U.S. 

Government Printing Office, Apr. 1966. 
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Table 1. Systolic and diastolic blood pressure of persons 7-74 years by age and sex, with means, standard deviations, and standard @
 error c.fmeans: United States. 1971-74


II 1 

Both sexes II Male I Female 

Bkmd pressure and age


SYSTOLIC


7-11 years


12-17 years
 18-24 years
 25-34 years
 35-44 years
 45-54 years
 55-64 years
 65-74 years


DIASTOLIC


7-11 years
 12-17 years
 18-24 years
 25-34 years


35-44 years


45-54 years
 55-64 years
 65-74 years


Standard Standard Standard Standard II Mean Standard Standard Mean Ideviation Mean error of deviation error of deviation “~wof mean mean 

Blood pressure in mm. S?S


12.1 0.65 103.3 0.93
 13.7 0.65 111.9 0.57
 13.8 0.67 114.8 0.59
 14.7 0.64 116.7 0.45
 17.6 0.81 123.6 0.64
 22.7 1.23 132.9 1.28
 23.5 1.16 144.0 0.94
 25.2 1.05 152.5 0.98


0.57 64.3
 0.38 69.0


0.52 71.5


:.f: 74.9


80.2
 0:68 83.6
 0.6S 86.6
 0.57 85.9


Table 2. Systolic and diastolic blood pressure of white s.ndNegro persons 7-74 years by age and sex, with means and standard error


of means: United States, 1971-74


White I Negro 

Blood pressure ‘oth ‘exe’ II Male Female I ‘oth ‘exes II Male ] Female 

and age


Standard I

Standard Standard Mean Ierror of / Mean error of Mean error of Mean mean mean mean 

SYSTOLIC


7-11 years
 12-17 years
 18-24 years
 25-34 years
 35-44 years
 45-54 years


55-64 years
 65-74 years


DIASTOLIC


7-11 years
 12-17 years


18-24 years
 25-34 years
 35-44 years


45-54 years
 55-64 years
 65-74 years


Blood pressure in mm.


103.1


112.0


115.1


116.2


122.6


131.1


143.0


151.6


65.3 64.2
 70.4 69.0
 76.4 71.3
 80.S 74.6
 84.2 79.3
 87.5 82.6
 86.4 86.2
 84.9 S5.4


Standard Standard Standard
 error of Mean error of Mean error of


mean mean mean


Hg


1.1s 1.32 1.17 1.46 1.26 2.20 0.88 1.61 1.19 2.29 :.;; 4.23 

3.57
 2:69 3.57


0.83 63.8 1.20 0.89
 0.82 71.1 0.95 1.02
 0.78 76.2 1.03 1.02
 0.86 84.3 1.60 ;.;;
 0.97 91.2 1.43
 1.82 91.9 2.45 2:20


1.77 93.4 2.23 2.23
 0.96 90.9 1.20 1.31


I

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5 

Table 3. Systolic and diastolic blood pressure of persons 7-74 years by geographic regic.n,annual family income, and sex, with
 means, age-adjustedmeans, and standard error of msans: United States, 1971-74


Both sexes 7-?4 years Male 7-74 years Female 7-74 years


Blood pressure, region,
 and annual family income Age- Standard Age- Standard ASe- Standard


Mean adjusted error of Mean adjusted error of Mean adjusted error of
 mean mean mean mean mean mean


GEOGRAPHIC REGION I Blood pressure in HEW Hg 

systolic: Northeast 123.4 123.1 0.91 124.0 124.1 0.81 122.s 122.0 1.15 

Midwest 124.2 124.7 0.65 125.8 126.0 0.75 122.5 123.2 0.79 

South 127.6 127.0 0.86 127.5 127.2 1.12 127.7 127.0 0.89 

Tiest--- 122.5 122.7 0.94 124.4 124.4 1.14 120.7 121.3 0.99 

Diastolic: Northeast 77.3 77.2 0,72 7s.3 78.4 0.62 76.3 75.9 0.95 

Midwest 78.2 7s.4 0.37 79.7 79.7 0.34 76.6 77.0 0.51 

South 78.8 78.5 0.57 79.7 79.6 0.69 77.9 77.6 0.62 

vest 77.0 77.2 0.s0 78.S 78.S 0.79 75.3 75.7 0.97 

ANNUAL FAMILY INCOMS I 

systolic: Less than $5,000----------- 130.4 126.4 0.74 12S.6 126.6 1.23 131.6 126.3 0.s2 

$5,000-$9,999-------------- 124.2 124.7 0.63 125.4 125.6 0.60 123.1 124.0 0.s4 

$10,000 or mOre------------ 122.0 123.3 0.40 124.3 124.8 0.46 119.5 121.s 0.54 

79.6 78.5 0.53 79.6 79.5 0.77 79.7 77.9 0.55
 77.9 7s.3 0.41 79.1 79.4 0.40 76.S 77.2 0.56


77.1 77.3 0.31 79.1 78.B 0.35 74.9 75.6 0.41


I 

� Table 4. Prevalence rates of definite hypertension among persons 1S-74 years by age and sex, with standard errors, population es­
 timates, and proportion with this condition t previously diagnosed: United States. 1971-74


Both sexes Men women 

Condition and age Rate ;tandard Rate Standard ?opulation Rate ;tandard ?opu lat ion 

per 100 ~rror 0f per 100 error of estimate per 100 :rror of estimate in in ion rate :housands population rate :housands population rate Ic!pulat


DEFINITE HYPERTENSION,


TOTAL1 18.1 0.58 23,171 19.2 0.77 11,656 17.1 0.76 11,515


1S-24 years 3.1 0.58 73s 4.s 1.10 0.31 194 

25-34 years 0.67 1,777 1.34 l,:E ::: 0.51 618 

35-44 years 1::: 1.12 3,492 1%; 1.92 2,043 12.3 1.01 1,449 

45-54 years 24.2 1.64 5,702 26.8 2.12 3,022 21.9 1.91 2,680 

55-64 years 33.2 1.66 6,257 32.3 2.18 2,875 34.0 2.0s 3,382 

65-74 years 40.7 1.60 5,205 T36.6
 1.74 2,014 43.9 2.03 3,191

DEFINITE HYPERTENSION 

NOT PSIWIOUSLY DIAGNOSED, TOTAL2 54.9 1.29 12,712 62.9 1.76 7,333 46.7 1.67 5,379 

18-24 years 25-34 years 

35-44 years 45-54 years 55-64 years 65-74 years 

(55.; 

57:9 

60.6 

48.6 

48.5 

9.45 

5.24 

3.13 

3.22 

3.10 

1.76 

505 1,165 

2,021 

3,458 

3,039 

2,525 

69.5 

66.9 

61.6 

65.1 

60.4 

60.5 

12.62 

7.57 

5.18 

3.82 

4.13 

2.24 

378 

776 

1,258 

1,967 

1,738 

1,216 

65.5 

63.0 

52.6 

55.6 

38.5 

41.0 

9.27 

5.33 

4.03 

4.42 

4.49 

2.30 

127 

389 

763 1,491 

1>301 

1,308 

Isystolic blood pressure of at least 160 mm. Hs ~r diastOlic bloOd press~e Of at least 95 IUM-N& 2Proport ion of persons with definite hypertension, as definedin footnote 1, who have never been told by their doctors that they had high blood pressure; standard error of proportions and population esttites. 
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6 

Table 5. Prevalence rates of definite hypertension among white and Negro persons 18-74 years by age and sex, with standard errors @


and proportion with this condition not previously dia losed:United States, 1971-74


White


Both‘exe’ II Men 

Condition and age
 Rate


fie


pOpu­


lation


DSFINITE HYPER­
 TENSION, ‘D3TAL 1
 17.0


18-24 years
 25-34 years ::;


35-44 years 13.6
 45-54 years 22.2


55-64 years 31.4
 65-74 years 39.3


DEFINITE HYPER­


TENSION NOT PRE-
 VIOUSLY~~~$NOSED,
 56.6


18-24 years 66.9
 25-34 years 69.1


35-44 years 63.3


45-54 years 61.9


55-64 years 50.4
 65-74 years 49.2


T Rate Standard P& Standard error of error of 

rate popu- rate lation 

---lt1
 1.51 64.5 2.00 

10.86 67.0 13.68 6.02 71.1 8.84 

:.;; 66.8 6.48 

64.3 3.74 3:18 62,1 ;.;; 1.95 61.9 

0.57 18.5 0.84 

0.65 4.9 1.29 

0.65 1.28 

1.09 1;:: 1.97 1.59 25.8 2.06 1.59 31.1 2.14 

1.72 35.3 1.85 

Negro 

Women Both sexes Men W,Omen


Rate Rate Rate Rate
 ;tandard per ;tandard ~ Standard ~ Standard
 !% srror of 100 mror of error of error of
 ?Opu- rate 10pu- rate 10pu- rate pOpu- rate
 Lation lation .ation Lation
1 

15.7 0.72 28.2 1.75 27.8 2.33 28.6] 2.28 

;.; 0.30 1.06 1.77 2,9 1.06 0.57 Ii:? 2.86 1::; 5.9s 10,2 1.95 :$; :.;$ 32.0 3.85 38.2 6.55 28.3 f.~; 44.0 6.31 36.8 7.95 .50.9 31:7 2:02 52.6 :.;$ 49.9 7.86 54.5 7:11 42.3 2.26 55.1 . 50.1 4.28 58.8 4.73 

48.2 1.86 47.2 3.87 54.9 5.13 41.2 4.66 

66.4 12.00 7s.1 8.91 90.4 ;:.;: 62.6 1s.33 65.0 6.67 54.0 11.52 52.0 57.0 12.55 57.5 4.57 39.6 4.94 38.2 S:82 6.79 

58.9 4.71 55.6 8.45 71.8 10.26 %:: 10.03 

39.9 )O:j 39.2 7.35 48.9 12.99 33.0 8.36 

41.2 . 43.7 4.67 51.0 4.70 39.1 5.58 

ISystolic blood pressure of at least 160 mm. H or diastolic blood pressure of at least 95 mm. Hg.
 ‘Proportionof persons with definite hype,rtensf
on, as defined in footnote 1,who have never been told by their doctors that they
 had high blood pressure; standard error of proportions and population estimates.


N3TE: There are an estimated 19.4 million white persons at ages 18.74 years out of 113.6 million and 3.7 million Negro persons
 at ages 18-74 years out of 13.0 million that have defkite hypertension as defined in footnote 1.


Table 6. Responses to selected medical history items by hyper~ensive status for persoaa 1S-74 years; population in thousands and
 ..-. -.
 percent: uritea states, 19t1-14


Definite Borderline Normotension fc least 105 mm Hg hypertension hypertension diastolic 

Medical history items Population ?Opulation Population k@&tiOn 

?ercent in Percent in ?ercent ?ercent thou;~nds :housands thousands :housands 

Total 18-74 years


IWS a Doctor Ever Told You That You Have


High Blood Pressure?


Yes, still have it--------------------------- Yes, not now---------------------------------

Yes, don’t know now-------------------------- No-------------------------------------------

Unknown 

If Yes, How Man~a~a:;,Ago Did You First


Less than 1 year-----------------------------
 1-5 years
 6-70 years


Not applicable,unknown


During the Past 6 Months, Have You Ever


Used Any Medicine, Pills, or Drugs for


High Blood Pressure?


Regularly


Occasionally


No-------------------------------------------


Unknown


23,171 100.0 23.413 100.0 81,353 100.0 6.172 100.0 

7,701 33.2 3,kzl 14.6 2,997 2,731 44.2 1,846 8.0 1,598 6.8 2,371 #4$ 904 562 596 ‘1: 

12,712 5::; 17,810 7;:: 75,282 2,716 44.0 7 0.0 21 0.1 107 4 0.1 

177 1.6 

5,343 2::: 3,22: 1::: 3,6% l,S% 25.1 

4,874 21.0 2,241 2,259 1,793 29.0 

12,777 55.1 17,866 7::! 75,424 2,732 44.3 

4,893 21.1 2,084 8.9 1,670 1,$:; 23.8 

831 309 233 

17,421 7::; 20,992 8&+ 79,33s 4,390 7::? 

27 0.1 28 0.1 112 4 0.1 —

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Prevalence estimates of hypertension in the civilian noninstitutionalized population 17 years of age and over in 1974, 

based on household interview findings from a special supplement used in the Health Interview Survey, will be reported in 

Advance Data (HRA) 77-1250, No. 2. 

SYMBOLS 

Data not available----------------------------------------

Category not applicable . . . 

Quantity zero -

Quantity more than Obut less than 0.05 ----- 0.0 

Figure does not meet standards of 

reliability or precision * 

GPO 909-342