tion. Only 51 percent of people with hypertension were told by physicians that they had elevated blood pressure and only 16 percent of them were taking medication to control it.

After the first 5 years of campaign implementation, reports of the National High Blood Pressure Education Program indicated that 69 percent of survey respondents had learned something about high blood pressure and 30 percent of the general population believed they could define normal blood pressure, though this was true of more whites (33 percent) than African-Americans (18 percent). Subsequent communication efforts focused on African-American audiences and their physicians. By the end of the 1970s, hypertension awareness had increased among African-American men (from 41 to 66 percent) and African-American women (from 53 to 87 percent). Actual treatment rates for hypertension among African-Americans increased from 24 to 35 percent for men and from 40 to 63 percent for women. However, African-Americans were still less aware and less likely to be treated for high blood pressure when compared to their white counterparts.

By 1994, three-quarters of the American public reported having their blood pressure measured every 6 months. Significant improvements were observed in awareness and treatment of hypertension among those with hypertension (Cooper et al., 1997), and age-adjusted mortality rates had declined by 53 percent for coronary heart disease and 60 percent for stroke since the 1970s. Mortality declines were observed for both genders and for African-Americans and whites (National Heart, Lung, and Blood Institute, 2000). Although mortality rates for coronary heart disease have declined substantially for all groups, the greatest decline by 1994 was documented for white males and the smallest decline was evident for African-American males (National Heart, Lung, and Blood Institute, 2000).

By 1999, reports of the Behavioral Risk Factor Surveillance System (BRFSS) indicated that as little as 0.3 percent (median) of the general population had never had their blood pressure taken by a health professional, while the median prevalence of blood pressure screening in the past 6 months was nearly 75 percent (Be-



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