American women have better control of high blood pressure but are more obese than men

A study of more than 30,000 Americans since 2001 has revealed significant differences in management of heart disease risk between women and men. 

The George Institute for Global Health at the University of Oxford examined rates and management of diabetes, high cholesterol, high blood pressure, body mass index (BMI) and smoking and found that while there had been some improvements, women were now more likely to be obese and men less likely to have their blood pressure and diabetes under control.

"The good news is that, since the Millennium, there have been reductions in blood pressure and cholesterol levels and in rates of smoking across adults in the United States. However, these rates leave much room for improvement, and the average BMI has gone up, with the greatest rise for women", said Dr Sanne Peters, Research Fellow in Epidemiology at The George Institute, UK who led the research published in Circulation.

“We also saw a welcome increase in the number of people who were managing their diabetes and high blood pressure. But, the vast majority; around two thirds of women, and 80% of men, still don’t have these conditions under control and that’s incredibly concerning.”

Heart disease is the leading cause of death worldwide and accounts for about one in three deaths in the United States. A significant share of heart disease can, however, be avoided by keeping blood pressure and cholesterol at healthy levels, by not smoking, and by maintaining a healthy weight.


  • Obesity - BMI increased more in women than men – up from an average BMI of 28.1 to 29.6 for women, and for men 27.9 to 29. Also by 2016, while 11% more men than women were overweight, obesity was 5% more common in women.
  • Cholesterol - Women fared worse than men in the control of cholesterol (the amount of this fatty substance in the blood) with levels decreasing by 44% more in men than women over the survey period – by 13mg/dL for men compared with only 9 mg/dL for women.
  • Diabetes – Rates of diabetes went up by 3% in both sexes; to 11% in women and 13% in men. Just 30% of women compared with 20% of men had their diabetes under control by 2016.
  • Blood Pressure – The number of people with high blood pressure dropped. From 43% of women to 42% and for men, from 51% to 49%. But, only 30% of women and 22% of men had adequate control of their hypertension by 2016.
  • Smoking – Smoking rates dropped from 22% to 18% in women and 29% to 22% in men.

Dr Peters added: “By assessing sex differences across major cardiovascular risk factors, this research offers crucial insight for individuals and clinicians aiming to better manage these risks. Further sex-specific research is needed to identify the relative impact of control or elimination of each factor in order to offer the most effective treatment for, and prevention from, heart disease.”

Researchers examined data between 2001 to 2016 from the United States National Health and Nutrition Examination Surveys of adults aged 20 to 79 years and compared results from the earliest four-year period (2001-04) to the latest period (2014-16).

The study was funded by the UK Medical Research Council and the Australian National Health and Medical Research Council.