Trends in Blood Pressure and Hypertension Detection, Treatment, and Control 1980 to 2009

Abstract

Background Hypertension is common and treatable but detection and control remain a major health challenge. This study sought to determine population trends in blood pressure and in the control of hypertension in the Minneapolis/St. Paul area (2010 population: 2.85 million) from 1980–2009. Methods and Results Surveys of risk factors were carried out every five years among randomly selected adults aged 25–74. Data on hypertension knowledge and use of medications were collected by interview. Blood pressure was measured using standardized methods with hypertension defined as blood pressure ≥140 and/or 90 mmHg or controlled (<140 and/or 90mmHg) on medications. Six surveys included 11,192 men and 12,795 women. Mean systolic blood pressure (SBP) fell from 124.9 mmHg in 1980–82 to 121.1 mmHg in 2007–09 for men (p<.0001) and for women from 120.1 mmHg to 114.7 mmHg (p<.0001). Similar trends for diastolic blood pressure wereobserved. Adults with uncontrolled blood pressure (≥140 and/or 90 mmHg) with or without medication fell from 20.3% to 5.8% (p<.001) for men and 13.1% to 2.7% (p<.0001) for women. Anti-hypertensive medication use rose to over 50% among all adults aged 55–74. Men (66%) and women (72%) with hypertension were treated and controlled by 2007–09. A majority of the decline in mean population blood pressure was the result of control with aggressive use of anti-hypertensive drugs. Stroke mortality in this population fell in parallel. Conclusions Hypertension detection and control in this community is among the highest observed in a US population and already exceeds Health People 2020 goals.

Guidelines on guidelines

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