The Bad News About Prevalence, the Good News About Treatments -- But Pay Attention to the Details

Linda Brookes, MSc


February 14, 2005

In This Article

Who Is Not Being Treated? Racial/Ethnic Disparities in Prevalence, Treatment, and Control of Hypertension Persist in the United States

An analysis of data from the National Health and Nutrition Examination Surveys (NHANES) for the 4-year period 1999-2002, conducted by researchers from the Centers for Disease Control and Prevention (CDC), appears to show that compared with the general population, non-Hispanic blacks in the United States have a higher prevalence of hypertension and Mexican Americans have lower rates of treatment and control. The CDC study is published in the January 14 issue of Morbidity and Mortality Weekly Report .[4]

The 4-year NHANES data were drawn from interviews with 7000 US adults aged ≥ 20 years and 5000 respondents who completed annual health examinations. For their analysis, the CDC abstracted data for non-Hispanic white, non-Hispanic black, and Mexican American individuals for whom blood pressure measurements were available. Hypertension was defined as mean SBP ≥ 140 mm Hg, DBP ≥ 90 mm Hg, or in those patients taking antihypertensive medication. Persons with hypertension were considered to be aware of their condition if they reported being told by a healthcare professional that their blood pressure was high; they were considered to have been treated if they reported using antihypertensive medication; and they were considered to have controlled hypertension if blood pressure was < 140/90 mm Hg.

During 1999-2002, the age-adjusted prevalence of hypertension in the study population overall was 28.6%, but 40.5% among non-Hispanic blacks compared with 27.4% among non-Hispanic whites and 25.1% among Mexican Americans. Overall, 63.4% of the study population had been told that their blood pressure was high. Awareness of hypertension was 70.3% among non-Hispanic blacks, 62.9% among non-Hispanic whites, and 49.8% among Mexican Americans.

Among those with hypertension, 45.3% had been treated with antihypertensive medication. The highest percentage treated, at 55.4%, was among non-Hispanic blacks, compared with 48.6% among non-Hispanic whites and 34.9% among Mexican Americans. Overall, only 29% of those with hypertension had controlled blood pressure levels. The proportion with controlled blood pressure was similar among non-Hispanic blacks (29.8%) and non-Hispanic whites (29.8%), but substantially lower among Mexican Americans (17.3%).

If national health objectives are to be met, the CDC researchers say, public health efforts must continue to focus on the prevention of hypertension and must improve awareness, treatment, and control of the condition among minority populations.


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