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As of 2005 data, at least 73.6 million people older than 20 years in the United States have hypertension, defined as systolic blood pressure greater than or equal to 140 mm Hg or diastolic blood pressure greater than or equal to 90 mm Hg, or both. This translates to one in four adults and more than half of those older than 60 years of age. The incidence of hypertension increases with age. If an individual is normotensive at age 55, the lifetime risk for hypertension is 90%. High blood pressure resulted in the death of 57,356 Americans in 2005. From 1995 to 2005, the death rate from hypertension rose 25.2% and the actual number of deaths rose 56.4%. Of persons with high blood pressure, 78.7% are aware of their diagnosis. Of this group, 69% are under treatment, 45% are well controlled, and 55% are not. Hypertension is most prevalent among the black population, affecting one of every three African Americans. Non-Hispanic blacks and Mexican Americans are also more likely to suffer from high blood pressure than non-Hispanic whites.

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Deaths/100,000 individualsRace/gender
52.1African American/male
40.3African American/female

The National High Blood Pressure Education Program (NHBPEP), which is coordinated by the National Heart, Lung, and Blood Institute (NHBLI) of the National Institutes of Health, was established in 1972. The program was designed to increase awareness, prevention, treatment, and control of hypertension. Data from the National Health and Nutrition Examination Survey (NHANES), conducted between 1976 and 2000, revealed that of patients aware of their high blood pressure and under treatment, the number who had achieved control of their high blood pressure had increased (Table 34-1). Coincident with these positive changes was a dramatic reduction in morbidity and mortality (40%-60%), including stroke and myocardial infarction (MI) secondary to hypertension. However, the most recent NHANES III survey, conducted in 1999-2000, showed a leveling off of improvement.

Table 34-1. Trends in Awareness, Treatment, and Control of High Blood Pressure in Adults Aged 18-71 Years.a

High blood pressure is ...

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