Public health and the control of high blood pressure at the state level: asleep at the switch or running low on fuel?

In the United States today, we know a great deal about the burden of high blood pressure (BP) and the inadequacy of its prevention and control at the national level.1 The National Health and Nutrition Examination Survey (NHANES), created through authorizing legislation of the National Health Survey Act of 1956, collects directly measured and selfreported data relevant to biological risk factors for cardiovascular disease, including high BP. Beginning in the early 1960s, NHANES has periodically provided health data (by number and percentage) on the US population, designated subgroups with high BP, and tracked trends in the prevalence, awareness, treatment, and control of this condition.2 In 1999, the program became a continuously running survey designed to collect data on a nationally representative sample of 5000 individuals for each year of the survey with release of data in 2-year cycles.3