Elevated blood pressure among U.S. adults with diabetes, 1988–19941
Section snippets
Background
In 1997, the sixth report of the Joint National Commission on the Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VI),1 for the first time, incorporated a risk-stratification scheme into treatment algorithms for high blood pressure that included the presence of cardiovascular risk factors, such as diabetes. For people with diabetes, the JNC-VI treatment guidelines recommended that lifestyle modifications and anti-hypertensive drug therapy be initiated for blood pressure ≥130/85
Methods
The National Center for Health Statistics of the Centers for Disease Control and Prevention conducted the NHANES III between 1988 and 1994 on a representative sample of the civilian, non-institutionalized population of the United States.9 The survey included an interview and a limited examination within the home, followed by a more extensive physical examination in a mobile examination center (MEC). Of the 39,695 sampled people, 86% (33,994) agreed to be interviewed and examined in their home
Prevalence and type of elevated blood pressure
Among U.S. adults with diabetes (9.1 million), 71.0% (6.4 million) had elevated blood pressure (i.e., blood pressure ≥130/85 mm Hg or current use of prescription medication for hypertension) (Table 1). The prevalence of elevated blood pressure was high among all age groups, but it increased with age, from 39.6% among people aged 18 to 44 years, to 71.5% among people aged 45 to 64 years, to 83.5% among people aged ≥65 years. Although the estimated prevalence of elevated blood pressure was
Conclusions
During 1988 to 1994, 71% of the U.S. adult population with diabetes had elevated blood pressure. The prevalence of elevated blood pressure increased with age and was high among both men and women and among Mexican Americans, non-Hispanic blacks, and non-Hispanic whites. Because the NHANES III was conducted prior to JNC-VI treatment recommendations, these data reflect how far we need to go rather than how well standards of care regarding detection, treatment, and control were being met at the
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