Nearly Half of U.S. Adults Have High Blood Pressure; About 1 in 4 Have It Controlled

Hypertension — high blood pressure — raises the risk of heart disease and stroke, two of the leading causes of death in the United States. Clinicians diagnose and treat it by comparing a patient's systolic and diastolic readings with set thresholds. Guidelines issued in 2017 by several organisations, including the American College of Cardiology (ACC) and the American Heart Association (AHA), define hypertension as blood pressure consistently at or above 130/80 mm Hg.

Million Hearts applied those criteria to the 2017–March 2020 National Health and Nutrition Examination Survey (NHANES) to estimate how many U.S. adults have hypertension, how they should be treated, and how many have it controlled.

Key facts

• Nearly half of adults — 119.9 million (48.1%) — have hypertension: blood pressure of 130/80 or higher, or taking medicine to lower it.
• Only about 1 in 4 of them — 27.0 million — have it under control (below 130/80). The other 92.9 million do not.
• A clinician recommends lifestyle changes for everyone with hypertension; for 25.0 million that is the only recommendation.
• 94.9 million (4 in 5) are also advised to take prescription medication.
• 33.2 million already on medication may need a higher dose or more medicines to reach control; more than half of them (18.8 million) have blood pressure of 140/90 or higher.
• 34.8 million for whom medication is recommended are not being treated; two-thirds of them (23.4 million) are at 140/90 or higher.

People advised to change their lifestyle only are counted as uncontrolled, because their blood pressure is above the threshold. Estimates may not add to 100% because of rounding. Breakdowns by sex, age, and race and Hispanic origin are in the Million Hearts tables.

Sources

• Million Hearts® (content from CDC), "Estimated Hypertension Prevalence, Treatment, and Control Among U.S. Adults" (figure dated May 12, 2023). https://millionhearts.hhs.gov/data-reports/hypertension-prevalence.html
• Guideline: Whelton P.K., et al., 2017 ACC/AHA guideline for the prevention, detection, evaluation and management of high blood pressure in adults, Hypertension 2018. Data: NHANES.
• Tables: Estimated hypertension prevalence tables (PDF).
• Rewritten in hubnx's own words.