Nearly one in two US adults meets criteria for hypertension under current clinical guidelines, highlighting the scale of cardiovascular risk nationwide, according to a recent report.
Hypertension, diabetes, obesity, and dyslipidemia remain highly prevalent in the US, with limited improvement in treatment and control over the past 15 years, according to Cardiovascular Statistics in the United States, 2026, published in the Journal of the American College of Cardiology. Using contemporary clinical definitions, hypertension affects a substantially larger share of the population than under historical thresholds, while diabetes prevalence has continued to rise, obesity now affects more than 40% of adults, and mortality related to several cardiovascular conditions has plateaued or increased following earlier declines. Across these conditions, the report documented persistent disparities by race, income, geography, and age.
Researchers synthesized data from nationally representative surveys, including the National Health and Nutrition Examination Survey (NHANES), along with administrative claims, clinical registries, vital statistics, and selected raw datasets analyzed directly by the investigative team. Estimates were age-standardized to the 2010 US Census population to support longitudinal comparisons. The report examined cardiovascular risk factors and five major conditions accounting for most cardiovascular deaths and disability in the US, with analyses stratified by demographic and socioeconomic characteristics.
Using historical diagnostic thresholds, hypertension prevalence remained stable at approximately 34% between 2009 and 2023; however, applying current guideline definitions increased prevalence estimates to 48%, with the highest rates observed among men and Black adults. Despite the availability of effective antihypertensive therapies, only about two-thirds of adults with hypertension received treatment, and blood pressure control rates showed little improvement over the past 15 years. Hypertension-related cardiovascular mortality nearly doubled between 2000 and 2019.
"We cannot improve what we do not measure, and we cannot accelerate progress without a shared understanding of where we are and where we have been," noted lead author Rishi K. Wadhera, MD, of the Division of Cardiovascular Medicine at Beth Israel Deaconess Medical Center, and colleagues.
Similar trends were observed for diabetes. Prevalence increased from 12% to 14% between 2009 and 2023, with sharper rises among younger adults, patients with low income, and Black adults. Only about half of adults with diabetes achieved glycemic control, and age-adjusted diabetes-related mortality increased substantially. Obesity prevalence rose from 35% to 40% between 2011 and 2023, while the use of bariatric surgery and anti-obesity pharmacotherapy remained limited despite evidence of benefit.
Mean low-density lipoprotein cholesterol (LDL-C) levels declined modestly at the population level over time. However, fewer than one-quarter of adults with established atherosclerotic cardiovascular disease achieved guideline-recommended LDL-C targets. Cigarette smoking declined overall but remained disproportionately common among patients with low income, with rates unchanged or increasing among older adults.
Full disclosures can be found in the published report.
Source: JACC