Prevalence, awareness, treatment, and control of hypertension in the inner city

This article reports on the prevalence, awareness, treatment, and control of hypertension in a predominantly black population residing in the inner city of Detroit, Michigan. The data reported come from a cross-sectional survey of approximately 800 adults conducted in the fall of 1978. The prevalence of hypertension in the population studied, 38%, was similar for men and women below age 55; above age 55, women were more likely to have high blood pressure than men. Hypertension was positively related to the respondent's age and weight, but was not associated with having a family history of hypertension, or with the amount of cigarettes smoked daily. Compared with estimates of awareness, treatment, and control status of hypertensives derived from community surveys conducted in the 1960s, our findings indicate substantial improvement in hypertension management among a predominately black, urban population during the past decade. Of the hypertensives identified in our sample, 80% were aware of their hypertension before participation in the survey, 86% of those previously detected were being treated for their hypertension, and 26% of those being treated were adequately controlled (BP <140/90 mm Hg). Awareness, treatment, and control rates appear to be age-related, with younger respondents less likely to be aware of their hypertension, on antihypertensive therapy, and successfully controlled. Below age 54, women were much more likely to be aware of their hypertension condition than men. Because of the lower detection rates among younger age groups it is recommended that future blood pressure screening efforts in the inner city be directed at younger adults (between the ages of 18 to 44), especially men.