Age-specific prevalence and factors associated with normal blood pressure among US adults.

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 three times and averaged. Normal BP was defined as SBP <120 mmHg and diastolic BP <80 mmHg among participants not taking antihypertensive medication. Those with SBP ≥120 mmHg, diastolic BP ≥80 mmHg, 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 versus elevated BP/hypertension was more common among those with moderate and no versus heavy alcohol consumption (prevalence ratio [PR] 3.03; 95%CI 1.25-7.36 and 2.53; 95%CI 0.96-6.65, respectively), ≥150 versus <150 minutes of physical activity per week (PR=1.44; 95%CI 1.01-2.05), overweight and normal weight versus 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 versus elevated BP/hypertension were less likely to have good or fair/poor versus excellent/very good self-rated health, diabetes, albuminuria, atherosclerotic cardiovascular disease and heart failure. CONCLUSION Among US adults ≥65 years, normal BP was associated with healthy lifestyle factors and a lower prevalence of adverse health conditions.