Statement from the National High Blood Pressure Education Program: prevalence of hypertension

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Abstract
The National High Blood Pressure Education Program (NHBPEP) is approaching its thirtieth anniversary. During the past quarter century the NHBPEP has reported periodically prevalence estimates of hypertension as new data became available. The primary source of data for these estimates has been cross-sectional population studies conducted by the National Center for Health Statistics, Centers for Disease Control and Prevention, the National Health and Nutrition Examination Surveys (NHANES). In determining prevalence, actual blood pressure measures and self-reported information have been used. The earliest program statements defined high blood pressure as ≥160 mm Hg systolic or 95 mm Hg diastolic (160/95), or taking medication for hypertension.1 When clinical trial data reported the benefits of beginning to treat blood pressure at lower levels, the NHBPEP lowered the blood pressure threshold criteria for defining hypertension from 160/95 to 140/90 mm Hg.2 This resulted in more Americans being labeled as hypertensive. Although 140/90 mm Hg or taking medication for hypertension is the current criterion to define hypertension, evidence from many sources indicates that blood pressure is related to the risk of cardiovascular and renal diseases in a continuous manner, even below the 140/90 mm Hg cut-off point. The Third NHANES (NHANES III) is the current and best source of data to estimate hypertension prevalence in the United States. This survey was conducted in two phases. Phase 1 was performed from 1988 through 1991 and phase 2 from 1991 through 1994. Estimates of hypertension prevalence, and the methods used to generate them, have been previously reported for Phase 1, 1988–1991.3

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