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.
OBJECTIVE
To describe hypertension trends in U.S. adults aged 60 and older using National Health and Nutrition Examination Survey (NHANES) data.


METHODS
NHANES III (1988-1994) and NHANES 1999 to 2004.


METHODS
Cross-sectional nationally representative health examination survey.


METHODS
Participants in NHANES III (n=5,093) and NHANES 1999 to 2004 (n=4,710).


METHODS
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.


CONCLUSIONS
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.
Ostchega
Yechiam
Y
Division of Health Nutrition Examination Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland 20782, USA. yxo1@cdc.gov
Dillon
Charles F
CF
Hughes
Jeffery P
JP
Carroll
Margaret
M
Yoon
Sarah
S
D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001364:Awareness; D001794:Blood Pressure / Q000502:physiology; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000208:ethnology / Q000503:physiopathology; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D015999:Multivariate Analysis; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D044465:White People
D000959:Antihypertensive Agents