HYPERTENSION PREVALENCE, AWARENESS, TREATMENT, AND CONTROL AMONG AFRICAN-AMERICANS IN THE 1990S - ESTIMATES FROM THE MAYWOOD CARDIOVASCULARSURVEY

During the last decade, the decline in cardiovascular disease mortalit y slowed among African Americans, compared to the general population. Hypertension control is likely to play an important role in determinin g these trends. The Maywood Cardiovascular Survey provides estimates o f the prevalence, awareness, treatment, and control of hypertension am ong African Americans. Between 1991 and 1993, we conducted a cardiovas cular disease survey among 1,524 African Americans living in the Chica go suburb of Maywood, Illinois. Estimates of the prevalence, awareness , treatment, and control of hypertension (defined as blood pressure [B P] greater than or equal to 140/90 mm Hg or self-reported taking of an tihypertensive medications) were calculated and compared to U.S. popul ation estimates for African Americans from NHANES II and III. The prev alence of hypertension in our sample was 32.7% (30.3, 35.1). After age -adjustment to the U.S. population, prevalence was 29.9% (27.9, 31.9), which is nonsignificantly lower than that reported for African Americ ans in NHANES III (32.4% [30.2, 34.6]). Awareness, pharmacologic treat ment, and control on pharmacologic treatment were 81%, 56%, and 55%, r espectively. These estimates are, respectively, 15%, 27%, and 42% high er than NHANES II and 7%, 9%, and 11% higher than NHANES III. Nonpharm acologic treatment alone may have accounted for up to 34% of hypertens ion control overall. Among previously diagnosed hypertensive subjects, risk factors for being untreated were male gender (odds ratio [OR] = 5.3 [1.3, 21.3]) and age < 45 years (OR = 3.8 [1.1, 12.8]), and for be ing uncontrolled was age greater than or equal to 65 years (OR = 1.9 [ 1.1, 3.0]). Rates of hypertension awareness, pharmacologic treatment, and control on pharmacologic treatment are higher in this sample of Af rican Americans than among African Americans in NHANES II and are comp arable to those in NHANES III. The impact of nonpharmacologic treatmen ts on control needs further consideration.