Epidemiology and prevention of hypertension.

At least 43 million (24%) adults in the general population of the United States have hypertension. The prevalence of hypertension increases with age and is higher among African-Americans compared to other ethnic groups. During the past several decades, the prevalence of hypertension in the general population of the United States has declined and the proportion of hypertensives who are aware of their high blood pressure, as well as the portion who are being treated and controlled has improved. Hypertension is the most important modifiable risk factor for coronary heart disease, stroke, congestive heart failure, and end-stage renal disease. To achieve the final goal of eliminating all blood pressure-related disease in the community, detection and treatment of hypertension must be complemented by equally energetic approaches directed at primary prevention of hypertension. A small downward shift in the entire distribution of blood pressure in the general population will not only reduce the incidence of hypertension, but substantially diminish the burden of blood pressure in the general population.