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Epidemiology of hypertension

Ngày 30/06/2016 10:12 | Lượt xem: 2593

Hypertension is a worldwide epidemic; accordingly, its epidemiology has been well studied. Data from National Health and Nutrition Examination Survey (NHANES) spanning 1999-2002 in the United States found that in the population aged 20 years or older, 

an estimated 41.9 million men and 27.8 million women had prehypertension, 12.8 million men and 12.2 million women had stage 1 hypertension, and 4.1 million men and 6.9 million women had stage 2 hypertension. Data from NHANES spanning 2003–2006 showed that 33.6% of US adults 20 years of age have hypertension, resulting in an estimated 74.5 million US adults with hypertension.

In many countries, 50% of the population older than 60 years have hypertension. Overall, approximately 20% of the world’s adults are estimated to have hypertension. The 20% prevalence is for hypertension defined as blood pressure (BP) in excess of 140/90 mm Hg. The prevalence dramatically increases in patients older than 60 years.

In a large Spanish epidemiologic study over a 10-year period, investigators found that despite an increase in the intensity of hypertensive therapy, the prevalence of uncontrolled hypertension (systolic BP [SBP] ≤140 mm Hg and/or diastolic BP [DBP] ≤90 mm Hg) did not change significantly over time. In addition, there appeared to be worse control in at-risk individuals (SBP ≤130 mm Hg and/or DBP ≤80-85 mm Hg) who had comorbidities.

Until age 45 years, a higher percentage of men than women have hypertension; from age 45 years onward, the percentages are nearly equal between men and women. In women, those who use oral contraceptives, particularly obese and older women, have a 2- to 3-fold higher risk of hypertension than women not using these agents.

Globally, black adults have among the highest rates of hypertension, with an increasing prevalence. Although white adults also have an increasing incidence of high BP, they develop this condition later in life than black adults and have much lower average BPs. In fact, compared to hypertensive white persons, hypertensive black individuals have a 1.3-fold higher rate of nonfatal stroke, a 1.8-fold higher rate of fatal stroke, a 1.5-fold higher mortality rate due to heart disease, and a 4.2-fold higher rate of end-stage renal disease (ESRD).

Table 1, below, summarizes age-adjusted prevalence estimates from the National Health Interview Survey (NHIS) and the National Center for Health Statistics (NCHS) according to racial/ethnic groups and diagnosed conditions in individuals 18 years of age and older.

Source emedicine.com

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