High Blood Pressure
(ICD/9 401-404) (ICD/10 I10-I15)

Prevalence

The overall estimated 2004 prevalence for high blood pressure (HBP) was 72,000,000 (33,000,000 males, 39,000,000 females).

HBP is defined as:
- Untreated systolic pressure of 140 mm Hg or higher, or diastolic pressure of 90 mm Hg or higher or taking antihypertensive medicine; or
- Being told at least twice by a physician or other health professional that you have HBP.
Nearly one in three U.S. adults has HBP. (Hypertension. 2004;44:398-404.)
A higher percentage of men than women have HBP until age 45. From ages 45–54, the percentage of men and women is similar. After that, a much higher percentage of women have HBP than men do. (Health, United States, 2005.)
HBP is two to three times more common in women taking oral contraceptives, especially in obese and older women, than in women not taking them. (Hypertension. 2003;42:1206-1252.)
Data from the BRFSS study of the CDC showed that in 2005, 25.5 percent of respondents had been told they had HBP. (http://apps.nccd.cdc.gov/brfss/index.asp)

Race/Ethnicity and HBP

The prevalence of hypertension in blacks in the United States is among the highest in the world, and it is increasing. From 1988-94 to 1999-2002, the prevalence of HBP in adults increased from 35.8 percent to 41.4 percent among blacks, and it was particularly high among black women, at 44.0 percent. Prevalence among whites also increased, from 24.3 percent to 28.1 percent. (Arch Intern Med. 2005;165:2098-2104.)
Compared with whites, blacks develop HBP earlier in life and their average blood pressures are much higher. As a result, compared with whites, blacks have a 1.3-times greater rate of nonfatal stroke, a 1.8-times greater rate of fatal stroke, a 1.5-times greater rate of heart disease death and a 4.2-times greater rate of end-stage kidney disease. (JNC 5 and 6)
Compared with white women, black women have an 85 percent higher rate of ambulatory medical care visits for HBP. (Vital Health Stat 13. 2001;149:1-46.)

Mortality

HBP mortality in 2004 was 54,186 (22,795 males, 31,392 females).
From 1994–2004, the age-adjusted death rate from HBP increased 25.2 percent and the actual number of deaths rose 54.6 percent. (NCHS and NHLBI)
The 2004 overall death rate from HBP was 17.9. Death rates were 15.6 for white males, 49.9 for black males, 14.3 for white females and 40.6 for black females. (NHLBI computation based on annual NCHS mortality data.)

Aftermath

About 69 percent of people who have a first heart attack, 77 percent who have a first stroke, and 74 percent with heart failure have blood pressure (BP) higher than 140/90 mm Hg. (NHLBI unpublished estimates from ARIC, CHS and FHS Cohort and Offspring Studies)
People with systolic BP of 160 mm Hg or higher and/or diastolic BP of 95 mm Hg or higher have a relative risk for stroke about four times greater than for those with normal BP. (Hypertens Res. 1994;17[suppl 1]:S23-S32.)
Hypertension precedes the development of heart failure in 91 percent of cases, and is associated with a two to three times higher risk for developing heart failure. (FHS; NHLBI; JAMA. 1996;275:1557-1562.)
Data from the FHS indicate that hypertension is associated with shorter overall life expectancy as well as shorter life expectancy free of cardiovascular disease (CVD) and more years lived with CVD. (Hyper-tension. 2005;46:280-286.)

HBP is associated with shorter life expectancy.

Pre-Hypertension

"Pre-hypertension" is untreated systolic pressure of 120 - 139 mm Hg, or untreated diastolic pressure of 80 - 89 mm Hg, and not being told on two occasions by a doctor or other health professional that you have hypertension.
It is estimated that 37.4 percent of the U.S. population age 20 and older has pre-hypertension, including 41,900,000 million men and 27,800,000 women. (Med Sci Monit. 2005;11:CR403-409.) End-Stage Renal Disease (ESRD) (ICD/10 N18 .0)
ESRD (also called end-stage kidney disease) is a condition that is most commonly associated with diabetes or high blood pressure and diabetes, and occurs when the kidneys can no longer function normally on their own.
The incidence of reported ESRD has almost doubled in the past 10 years. (NHLBI)
In 2003, 102,567 new cases of ESRD were reported. (www.usrds.org)
Nearly 453,000 patients were being treated for ESRD by the end of 2003. (www.usrds.org)
82,588 patients died from ESRD in 2003. (www.usrds.org)
More than 15,700 kidney transplants were performed in 2003. (www.usrds.org)
Diabetes continues to be the most common reported cause of ESRD. (www.usrds.org) Source: NCHS and NHLBI; Health, United States, 2005. NH = non-Hispanic. AA = African American