Racial disparities in hypertension prevalence, awareness, and management

Arch Intern Med. 2005 Oct 10;165(18):2098-104. doi: 10.1001/archinte.165.18.2098.


Background: Effectively reducing cardiovascular disease disparities requires identifying and reducing disparities in risk factors. Improved understanding of hypertension disparities is critical.

Methods: Cross-sectional analysis of nationally representative samples of black and white adults 20 years and older who participated in the National Health and Nutrition Examination Survey (NHANES) 1999-2002 (white, n = 4624; black, n = 1837) and NHANES III conducted in 1988-1994 (white, n = 7121; black, n = 4709). We examined differences in hypertension prevalence, awareness, treatment, and blood pressure (BP) control among both treated and prevalent cases across the 2 periods.

Results: Hypertension prevalence increased significantly from 35.8% to 41.4% among blacks and from 24.3% to 28.1% among whites and remains significantly higher among blacks. Awareness is higher among blacks (77.7% vs 70.4%; P<.001), as is treatment (68.2% vs 60.4%; P<.001). These results are driven by higher rates in black women. Blood pressure control rates among those treated have increased in both races, primarily as a result of increased BP control in black and white men (27.3% and 44.7%, respectively; P<or=.03). Despite the improved BP control rates, disparity in BP control among treated cases increased, with 59.7% of treated whites and 48.9% of treated blacks now reaching BP goal (P<.001). Racial differences in BP control rates among those treated cannot be explained by nonpharmacologic management or health insurance, but educational attainment is associated with BP control.

Conclusion: The higher prevalence of hypertension in blacks and the growing disparity in BP control among those treated pharmacologically are causes for concern.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Awareness
  • Black People / statistics & numerical data
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / epidemiology
  • Hypertension / ethnology*
  • Hypertension / therapy*
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Prevalence
  • United States / epidemiology
  • White People / statistics & numerical data