Table 7 provides estimates for prevalence of hypertension in the US general adult population ( 20 years of age) that are based on the definitions of hypertension rec- ommended in the present guideline and in the JNC 7 report. The prevalence of hypertension among US adults is substan- tially higher when the definition in the present guideline is used versus the JNC 7 definition (46% versus 32%). However, as described in Section 8.1, nonpharmacological treatment (not antihypertensive medication) is recommended for most US adults who have hypertension as defined in the present guideline but who would not meet the JNC 7 definition for hypertension. As a consequence, the new definition results in only a small increase in the percentage of US adults for whom antihypertensive medication is recommended in conjunction with lifestyle modification. The prevalence of hypertension rises dramatically with increasing age and is higher in blacks than in whites, Asians, and Hispanic Americans. NHANES estimates of JNC 7 defined hypertension prevalence have remained fairly stable since the early 2000s.S3.3-1 Most contemporary population sur- veys, including NHANES, rely on an average of BP measure- ments obtained at a single visit,S3.3-2 which is likely to result in an overestimate of hypertension prevalence compared with what would be found by using an average of 2 read- ings taken on 2 visits,S3.3-1 as recommended in current and previous BP guidelines.S3.3-3 S3.3-5 The extent to which guide- line recommendations for use of BP averages from 2 occa- sions is followed in practice is unclear. Adding self-report of previously diagnosed hypertension yields a 5% to 10% higher estimate of prevalence.S3.3-1,S3.3-6,S3.3-7 Most individuals who were added by use of this expanded definition have been diagnosed as having hypertension by a health professional on >1 occasion, and many have been advised to change their 3.4. 