Estimated Hypertension Prevalence, Treatment, and Control Among U.S. Adults

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Hypertension, also known as high blood pressure, increases the risk for heart disease and stroke, two leading causes of death for people in the United States.1

Clinicians diagnose patients as having hypertension and make treatment decisions by comparing patients’ systolic and diastolic blood pressure readings to certain thresholds.

The hypertension thresholds that clinicians use for diagnosis and patients’ treatment plans may differ from clinician to clinician:

  • Some health care professionals diagnose patients with hypertension if their blood pressure is consistently 140/90 mm Hg or higher. This limit is based on guidelines and recommendations released in 2003 and 2014.2,3
  • Other health care professionals diagnose patients with hypertension if their blood pressure is consistently 130/80 mm Hg or higher. This limit is based on the American College of Cardiology and American Heart Association’s (ACC/AHA) hypertension clinical practice guideline that was released in 2017.4

Application of the ACC/AHA 2017 Guidelines

The following figure highlights the number of adults aged 18 years and older in the United States who have hypertension. This figure applies criteria from the 2017 ACC/AHA guideline to NHANES 2013 to 2016 data.

The figure also shows the number of

  • People with hypertension who are recommended to use either lifestyle modifications only or lifestyle modifications with prescription medication to manage their blood pressure.
  • People with hypertension who do not have their blood pressure controlled below 130/80 mm Hg.
  • People who are recommended to use prescription medication but are either untreated or are treated but whose hypertension is not under control.
  • People who have a blood pressure at or above 140/90 mm Hg, also known as stage 2 hypertension, and are particularly in need of lowering their blood pressure.

Figure 1.

This figure describes hypertension prevalence, treatment, and control estimates among US adults aged 18 years and older when the criteria from the American College of Cardiology and American Heart Association’s 2017 Hypertension Clinical Practice Guideline are applied to data collected during 2013 to 2016 within the National Health and Nutrition Examination Survey. The figure shows that nearly 1 out of 2 adults in the United States has hypertension. Many adults with hypertension in the United States are recommended lifestyle modifications only. Almost all adults with hypertension in the United States who have been recommended lifestyle modifications only do not have their hypertension under control. Most adults with hypertension in the United States are recommended prescription medication with lifestyle modifications. Most adults with hypertension in the United States who have been recommended prescription medication and lifestyle modifications do not have their hypertension under control. Many adults in the United States who are recommended hypertension medication may need a prescription and may need to start taking it. Two-thirds of this group have a blood pressure of 140/90 mm Hg or higher. Many adults in the United States who are already treated with hypertension medication may need their prescription changed to achieve blood pressure control; 31.2 million adults in the United States using hypertension medication still have a blood pressure of 130/80 mm Hg or higher. More than half of this group have a blood pressure of 140/90 mm Hg or higher.

Key Findings

The key findings shown in Figure 1. include the following:

  • Nearly 1 out of 2 adults in the United States has hypertension (116 million).
  • Approximately 1 in 5 adults with hypertension in the United States are recommended lifestyle modifications only (24.3 million).
  • Most adults with hypertension in the United States are recommended prescription medication with lifestyle modifications (91.7 million).
  • Most adults with hypertension in the United States do not have their hypertension under control (92.1 million). This includes all 24.3 million adults who are recommended lifestyle modifications only and 67.8 million adults who are recommended lifestyle modifications and prescription medication.
  • Many adults in the United States who are already treated with hypertension medication may need to have their current medication dosage increased or to be prescribed additional medications to achieve blood pressure control (33.6 million). More than half of this group have a blood pressure of 140/90 mm Hg or higher (20.0 million).
  • Many adults in the United States for whom hypertension medication is recommended are untreated and may need both a prescription and to start taking it (34.1 million). Two-thirds of this group have a blood pressure of 140/90 mm Hg or higher (23.2 million).

For more information about individual subgroups, please see

  • Table 1. Hypertension prevalence and control estimates among U.S. adults aged 18 years and older applying criteria from the American College of Cardiology and American Heart Association’s (ACC/AHA) 2017 Hypertension Clinical Practice Guideline, by sex, age and race-Hispanic origin—NHANES 2015–2018.
  • Table 2. Treatment estimates among U.S. adults aged 18 years and older with uncontrolled hypertension recommended blood pressure medication use applying criteria from the American College of Cardiology and American Heart Association’s (ACC/AHA) 2017 Hypertension Clinical Practice Guideline, by sex, age and race-Hispanic origin—NHANES 2015–2018.

For More Information

For more information, email MillionHearts@cdc.gov.

References

  1. Kochanek KD, Murphy SL, Xu J, Arias E. Deaths: Final Data for 2017 [PDF – 1.76 MB]. National Vital Statistics Reports. 2019;68(9). Hyattsville, MD: National Center for Health Statistics.
  2. National High Blood Pressure Education Program. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [PDF – 223 KB]. Bethesda, MD: National Heart, Lung, and Blood Institute; 2003.
  3. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507-20.
  4. Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Hypertension. 2018;71(19):e13–115.

Suggested Citation for Figure 1

Centers for Disease Control and Prevention (CDC). Hypertension Cascade: Hypertension Prevalence, Treatment and Control Estimates Among US Adults Aged 18 Years and Older Applying the Criteria From the American College of Cardiology and American Heart Association’s 2017 Hypertension Guideline—NHANES 2015–2018. Atlanta, GA: US Department of Health and Human Services; 2021.