Elevated blood pressure is the most important cardiovascular risk factor, contributing to about 50% of coronary heart disease and 66% of cerebrovascular disease events. This study examined trends in blood pressure using data from the third National Health and Nutrition Examination Survey (1998-1994) and the 1999-2004 National Health and Nutrition Examination Survey broken down by sex and ethnicity. During that period, the prevalence of hypertension (systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or on antihypertensive medication) increased from 24.4% to 28.9% (p<0.001), the largest increase being observed in non-Hispanic women. Moreover, there was an increase in the prevalence of hypertension in all body mass index subgroups, irrespective of sex and ethnicity. In hypertensive individuals, awareness slightly increased from 68.5% to 71.8% (p<0.05) but only in men. Increases in treatment and control rates were greater (53.1% to 61.4% and 26.1% to 35.1%, respectively, p<0.001) but again were only significant in men. These results suggest that although major progress have been made in the awareness, treatment, and control of hypertension, there is still a need to pursue interventions in order to prevent and reduce the vicious and deleterious hypertensive state. The paper was accompanied by an editorial by Theodore A. Kotchen who emphasized the critical importance of weight loss as a strategy to promote hypertension prevention, particularly in children and adolescents, because of the increased prevalence of overweight and obesity in these age groups. Moreover, he also underlined the importance of conducting long-term trials to document the impact of weight loss on blood pressure.
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