Trends in Hypertension Prevalence, Awareness, Treatment, and Control in Older U.S. Adults: Data from the National Health and Nutrition Examination Survey 1988 to 2004

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 55; no. 7; pp. 1056 - 1065
• Main Authors: Ostchega, Yechiam, Dillon, Charles F., Hughes, Jeffery P., Carroll, Margaret, Yoon, Sarah
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.07.2007; Blackwell; Wiley Subscription Services, Inc
• Subjects: African Americans; Age Factors; Aged; Aged, 80 and over; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Awareness; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure - physiology; Cardiology. Vascular system; Confidence Intervals; Cross-Sectional Studies; Epidemiology; European Continental Ancestry Group; Female; Follow-Up Studies; Gender differences; General aspects; Humans; Hypertension; Hypertension - drug therapy; Hypertension - ethnology; Hypertension - physiopathology; JNC 7; Male; Medical sciences; Medical treatment; Mexican Americans; Middle Aged; Multivariate Analysis; NHANES; Older people; Population Surveillance - methods; Prevalence; prevention and control; Prognosis; Proportional Hazards Models; Public health. Hygiene; Public health. Hygiene-occupational medicine; Racial differences; Retrospective Studies; Risk Factors; Sex Factors; therapy; Trends; United States - epidemiology; United States; Medical data; Prevalence; Awareness; Cardiovascular disease; Public inquiry; Epidemiology; Regulation(control); 2004; Adult; Age; Public health; Human; Hypertension; JNC 7; Nutrition; therapy; Trend; aged; Feeding; Health status; Treatment; Surveillance; NHANES; prevention and control; Elderly
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2007.01215.x

OBJECTIVES: To describe hypertension trends in U.S. adults aged 60 and older using National Health and Nutrition Examination Survey (NHANES) data. SETTING: NHANES III (1988–1994) and NHANES 1999 to 2004. DESIGN: Cross‐sectional nationally representative health examination survey. PARTICIPANTS: Participants in NHANES III (n=5,093) and NHANES 1999 to 2004 (n=4,710). MEASUREMENTS: Blood pressure (BP). RESULTS: In 1999 to 2004, 67% of U.S. adults aged 60 and older years were hypertensive, an increase of 10% from NHANES III. Between 1988 to 1994 and 1999 to 2004, hypertension control increased for men from 39% to 51% (P<.05) but remained unchanged for women (35% to 37%; P>.05). Non‐Hispanic black men and women had higher prevalences of hypertension than non‐Hispanic whites (odds ratio (OR)=2.54, 95% confidence interval (CI)=1.90–3.40 and OR=2.07, 95% CI=1.31–3.26, respectively), but men were less likely to have controlled BP (OR=0.60, 95% CI=0.41–0.86). Mexican‐American men and women were less likely than non‐Hispanic whites to have controlled BP (OR=0.55, 95% CI=0.33–0.91 and OR=0.63, 95% CI=0.40–0.98, respectively). Women and men aged 70 and older were significantly less likely to control their hypertension than those aged 60 to 69. In addition, women aged 70 and older were significantly less aware and treated. Having BP measured within 6 months was significantly associated with greater awareness, greater treatment in men and women, and greater control in women. A history of diabetes mellitus or chronic kidney disease (CKD) was significantly associated with less hypertension control. CONCLUSION: There was a significant increase in hypertension prevalence from 1988 to 2004. Hypertension control continues to be problematic for women, persons aged 70 and older, non‐Hispanic blacks and Mexican Americans, and individuals with diabetes mellitus and CKD.