Prevalence and changes of untreated isolated systolic hypertension among non-Hispanic black adults in the United States

Isolated systolic hypertension (ISH) is a growing health concern in the United States (US) black population. The stratified prevalence of untreated ISH has not been fully investigated in non-Hispanic blacks. Cross-sectional data on 4625 non-Hispanic blacks aged ⩾18 years were collected from the National Health and Nutrition Examination Survey 1999-2010, representing a probability sample of the US civilian noninstitutionalized black population. The 6-year prevalence of ISH and 95% confidence intervals (CIs) were estimated by conducting weighted frequency and logistic procedures. The prevalence of untreated ISH was 11.2% among non-Hispanic black adults in 1999-2010. Individuals who received lower education (high school or below) had higher prevalence of untreated ISH than those with higher education (12.8% (95% CI: 11.3-14.2%) vs. 9.0% (95% CI: 7.5-10.6%)). The prevalence of untreated ISH was higher in young men than in young women (4.3% (95% CI: 3.3-5.4%) vs. 1.8% (95% CI: 0.9-2.7%)), and higher in middle-aged adults with lower education than in middle-aged adults with higher education (14.1% (95% CI: 11.4-16.7%) vs. 7.7% (95% CI: 5.5-9.8%)). Compared with 1999-2004, the prevalence of untreated ISH in 2005-2010 decreased for old individuals (27.7% vs. 40.8%), old men (24.4% vs. 40.0%) and old individuals who received higher education (21.4% vs. 40.7%). Untreated ISH is more prevalent in old blacks, and significant reduction of the prevalence in this group suggests that public health interventions, lifestyle modifications or health awareness are in the right direction.