Progress in the battle against hypertension. Changes in blood pressure levels in the United States from 1960 to 1980.

Intensive efforts by practicing physicians and public health workers to identify and treat persons with hypertension have been underway for many years. In this report, changes in blood pressure levels in the United States are assessed based on nationally representative health (and nutrition) examination surveys conducted by the National Center for Health Statistics in 1960 to 1962, 1971 to 1974, and 1976 to 1980. Analysis of age-adjusted data for adults aged 18 to 74 years (including those on antihypertensive medication) indicates that between the first and third surveys for whites and blacks, respectively, mean systolic blood pressure declined 5 and 10 mm Hg; the proportion of persons with systolic blood pressure of 140 mm Hg or higher fell 18 and 31%; the proportion with undiagnosed hypertension decreased 17 and 59%; and the proportion taking antihypertensive medications rose 71 and 31%. These differences between the first and third surveys were all statistically significant (p less than 0.05 or better). Changes in diastolic blood pressure levels were generally not significant among race-sex groups. The proportion of persons with definite hypertension (i.e., systolic blood pressure greater than or equal to 160 mm Hg, and/or diastolic blood pressure greater than or equal to 95 mm Hg, and/or taking antihypertensive medication) declined among blacks but rose slightly among whites. Study results are consistent with the recent decline in cardiovascular disease mortality.

Dietary calcium and blood pressure in National Health and Nutrition Examination Surveys I and II.

It has recently been reported that a low intake of calcium may be a risk factor for hypertension. In view of the contradictory results, even when the same survey data base has been used by different researchers, an in-depth analysis was undertaken of the data provided by the two cycles of the National Health and Nutrition Examination Survey (NHANES). Both surveys, conducted in consecutive 4-year intervals during the 1970s, were designed to examine representative samples of the U.S. civilian noninstitutionalized population. The overall descriptive findings in relation to mean blood pressure and calcium intake were virtually identical in the two surveys. Based on "quantile" analysis, neither mean levels of blood pressure nor the prevalence of hypertension was related to calcium intake. Only among black men in NHANES I was a relationship between calcium intake and blood pressure noted. This finding was not apparent among black men in NHANES II or among any of the other sex-race groups in either survey. We conclude that the data of NHANES I and II do not show an association between low calcium intake and blood pressure.

Physical growth: National Center for Health Statistics percentiles.

Anthropometry is an effective and frequently performed child health and nutrition screening procedure. The value of physical growth data depends on their accuracy and reliability, how they are recorded and interpreted, and what follow-up efforts are made after identification of growth abnormality. The new National Center for Health Statistics percentiles can be used to improve identification of potential health and nutritional problems and to facilitate the epidemological comparison of one group of children with others.

The prevalence of pulmonary hypertension in the United States. Adult population estimates obtained from measurements of chest roentgenograms from the NHANES II Survey.

Because a definitive diagnosis of pulmonary hypertension requires cardiac catheterization, there have been no data on the prevalence of pulmonary hypertension in the general population. The diameter of the right descending pulmonary artery, as measured from chest roentgenograms, has been used by clinicians as a noninvasive indicator of pulmonary hypertension. Chest roentgenograms from the Second National Health and Nutrition Examination Survey, a sample survey of the US civilian noninstitutional population, were used in conjunction with estimates of sensitivity and specificity of this technique determined from patients who underwent right heart catheterization to estimate the prevalence of pulmonary hypertension (mean pulmonary artery pressure greater than 20 mm Hg at rest) in the US population aged 25 years and older. The prevalence is estimated to be very low in the population at large, primarily because of the low prevalence in women of all ages. The prevalence in men is 13.4 percent above age 34, and increases to 28.2 percent above age 64. Thus, in elderly men, pulmonary hypertension is relatively common and may have an important impact in the management of this age group.

Circumcision in the United States.

The circumcision status of boys aged 12 through 17 years (born from 1949 to 1958) from a sample cohort of the National Health Examination Survey (NHES) cycle III, conducted from 1966-70, was analyzed. Over three-fourths of the cohort had been circumcised, reflecting circumcision practices in the 1950s. Prevalence of circumcision was more common in Whites, in families with higher income, and higher educated heads of household. Circumcision prevalence was the lowest in the South and highest in the Midwest. More recent national data are not available.

Roentgenographic determination of total lung capacity: normal values from a National Population Survey.

Planimetric measurements of total lung capacity (TLC) were made from posteroanterior and lateral chest roentgenograms obtained during a nationwide survey of the civilian, noninstitutionalized United States population. Regression equations for TLC, residual volume (RV), and the ratio of RV to TLC for healthy, nonsmoking participants are presented. The equations predict values that agree closely with previously published normal values obtained by other methods.

Blood Pressure levels of Children 6-11 Years: Relationship to Age, Sex, Race, and Socioeconomic Status, United States.

This report presents the distribution of blood pressure levels of U.S. children aged 6-11 years by age, sex, and race. Data were obtained in Cycle II of the Health Examination Survey (HES), which is one of the major programs of the National Center for Health Statistics (NCHS) concerned with assessingthe health status of the U.S. population. The program consists of a series of surveys in which information is obtained on a probability sample of the U.S. population through examination, interview, measurement, and testing. In Cycle II of the HES, a representative sample of all noninstitutionalized children 6-l 1 years of age in the United States was obtained. From July 1963 through December 1965, the survey staff examined 7,119 children, 96 percent of the original sample of 7,417. A description of the sampling process, program operation, and response rates has been published previous1y. The standardized examination, given during a single visit, was primarily concerned with assessing health factors related to growth and development. Additionally, measurements of visual and auditory acuity were made, and evidence of the presence of congenital abnormalities, ear-nose-throat conditions, heart disease, and neuromusculoskeletal abnormalities was sought.