The epidemiology of hypertension control in populations

Despite an aging population, prevalence rates for hypertension in the U.S. remain stable due to a decrease in rates in women but a corresponding increase in rates for men. Epidemiological factors which may contribute to these rates are discussed. The lack of a threshold for the association between blood pressure and disease events means that the majority of events occur in the larger number of people with mild disease. Because the efficacy and cost-effectiveness of medical therapy to lower mildly elevated blood pressure remains controversial, population-based strategies to effect behavior change are the most prudent course for this, the largest group at risk. Targeted, resource-intensive medical intervention for those at high risk combined with hygienic measures for the population with mildly elevated blood pressure from the basis for an effective public health strategy.