Age-Specific Prevalence and Factors Associated With Normal Blood Pressure Among US Adults

Abstract

Abstract Background The mean systolic blood pressure (SBP) for US adults increases with age. Determining characteristics of US adults ≥65 years with normal blood pressure (BP) may inform approaches to prevent this increase. Methods We analyzed US National Health and Nutrition Examination Survey 2011–2018 data (n = 21,581). BP was measured up to 3 times and averaged. Normal BP was defined as SBP <120 mm Hg and diastolic BP (DBP) <80 mm Hg among participants not taking antihypertensive medication. Those with SBP ≥120 mm Hg, DBP ≥80 mm Hg, self-reporting having hypertension or taking antihypertensive medication were categorized as having elevated BP or hypertension. Results The prevalence of normal BP was 57.8%, 25.3%, 11.2%, and 5.0% among US adults who were 18–44, 45–64, 65–74, and ≥75 years, respectively. After multivariable adjustment, in US adults ≥65 years of age, normal BP vs. elevated BP/hypertension was more common among those with moderate and no vs. heavy alcohol consumption (prevalence ratio [PR] 3.03; 95% confidence interval [CI] 1.25–7.36 and 2.53; 95% CI 0.96–6.65, respectively), ≥150 vs. <150 minutes of physical activity per week (PR = 1.44; 95% CI 1.01–2.05), overweight and normal weight vs. obesity (PR = 1.88; 95% CI 1.22–2.90 and 2.94; 95% CI 1.89–4.59, respectively), and a high Dietary Approaches to Stop Hypertension score (PR = 1.43; 95% CI 1.00–2.05). US adults ≥65 years with normal BP vs. elevated BP/hypertension were less likely to have good or fair/poor vs. excellent/very good self-rated health, diabetes, albuminuria, atherosclerotic cardiovascular disease, and heart failure. Conclusions Among US adults ≥65 years, normal BP was associated with healthy lifestyle factors and a lower prevalence of adverse health conditions.