Abstract Body: Background: Although lifetime risk assessments provide valuable insights into disease burden, to our knowledge, there is only one study estimating the lifetime risk of hypertension in the US, using the current definition (≥130/80 mmHg). However, that study used data from three research cohorts not representative of the US population and lacks data on Hispanics.
Aim: To estimate lifetime risk of hypertension in the US, using the contemporary definition and nationally representative data.
Methods: Using the National Health and Nutrition Examination Survey 1999-2018 (N=44,056) and vital statistics, we estimated the prevalence and incidence of hypertension (i.e., ≥130/80 mmHg or antihypertensive medication use) at each year of age from birth to age 80 years) by sex and race/ethnicity (Whites, Blacks, and Hispanics). We, then, estimated the cumulative incidence of hypertension up to 80 years using Monte Carlo simulations.
Results: The lifetime risk of hypertension reached ~80-85% regardless of sex and race/ethnicity (Figure). However, the patterns of reaching this level of lifetime risk of hypertension varied considerably by race/ethnicity, with the age reaching the cumulative incidence of 50% ~40 years in Blacks vs. ~50 years in Whites and Hispanics. Black women exhibited a higher cumulative incidence of hypertension than White and Hispanic men at any point in life.
Conclusions: Four in five Americans develop hypertension in their lifetime, regardless of sex and race/ethnicity. However, Blacks develop hypertension much earlier than Whites and Hispanics. These findings emphasize the need for public health interventions to prevent hypertension in the US, and such an intervention should reach Black youth and younger adults.