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Indicator Details — Children and Adolescents: Percentage of Children and Adolescents Having Hypertensiona
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a Hypertension was defined as self- or guardian-reported hypertension, or systolic or diastolic blood pressure at or above 95th percentile for the child’s age, height, and gender (Working Group on High Blood Pressure in Children and Adolescents, 2004) for those children <18 years old. For 18- to 19-year-olds, self-report or the standard cutoffs of 140 and 90 mmHg for systolic and diastolic blood pressure were used to define hypertension.

Among U.S. children and adolescents aged 8- to 19-years-old, 3% had hypertension in 2015-2016.

The prevalence of hypertension in children and adolescents significantly decreased (p=.005) between the periods 1999-2000 and 2015-2016.
Chart Explanation: Children and adolescents with uncontrolled hypertension are at risk for adult hypertension and CKD. In 2015-2016, the overall prevalence of hypertension was 3.0% in children and adolescents aged 8-19 years had an overall prevalence. During this specific period, hypertnesion was more prevalent in children (3.9% for ages 8-9 years), male (3.3%), and Mexican-American (4.7%) children and adolescents than in their counterparts. Comparisons across groups were only significant for race/ethnicity (X2 test p=0.02).

Between 1999 and 2016, the percent of children and adolescents with hypertension began to decline during the priod 2007-2008. Prevalence continued to significantly decrease in the following years (p=.005).
The NHANES (National Health and Nutrition Examination Survey) is a nationally representative, cross-sectional survey that is currently conducted every 2 years by the Centers for Disease Control and Preventions National Center for Health Statistics to examine disease prevalence and trends over time in noninstitutionalized U.S. civilian residents.

The survey consists of a standardized in-home interview and a physical examination and blood and urine collection at a mobile examination center (MEC). Here we examined data from the 1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, 2013-2014, and 2015-2016 NHANES. Self-reported hypertension was defined by answer of “yes” (by child or parent or guardian) to the question “have you ever been told by a doctor that you have hypertension, or high blood pressure?” (16+ years only). Blood pressure was measured in NHANES participants aged 8 years and older using standardized protocols and the average of up to four measurements was taken. For those aged 8-17, blood pressure ≥95th percentile for age, height, and gender was considered high blood pressure (National Heart Lung and Blood Institute, 2004); for those aged 18 or 19, high blood pressure was defined as ≥140/≥90 mmHg as in adults. Either self-reported hypertension or measured high blood pressure defined hypertension.
Description of MeasurePrevalence of hypertension in children & adolescents
Data SourceNCHS
Type of Data SourcePublic
Health Care System DataNo
Regional or National?National
Demographic GroupNon-institutionalized U.S. residents aged 8-19 years
NumeratorParticipants 8-19 with self-report or blood pressure measurements >140/90 mmHg (18-19 years) or ≥95th percentile for age, height, and gender (8-17 years only)
DenominatorParticipants 8-19 with completed surveys or blood pressure measurements
Primary Data Source Indicatorbpq020: “Have you ever been told by a doctor or health professional that you have high blood pressure?” yes/no
Primary Indicator Method of MeasurementQuestionnaire (interviewer-administered); ages 16+
Secondary (1) Variablebpxsy1-bpxsy4: Up to four blood pressure measurements
Secondary (1) Indicator Method of MeasurementExamination/Laboratory
Secondary (2) Variablenhcode/rxddrgid: generic drug codes
Secondary (2) Indicator Method of MeasurementQuestionnaire (interviewer-administered), with recording of medications from Rx bottles
Frequency of Measurement (Primary)Once (cross-sectional)
U.S. Region Covered by Primary VariableAll
Period Currently Available1999–2016
Pending Data2017-2018
Additional Data Items of InterestStratification variables of interest (age, gender, race/ethnicity, BMI, hypertension by self-report)
Limitations of IndicatorBlood pressure in age 8+ only; interview in age 16+ only
Analytic ConsiderationsAppropriate NHANES survey weights must be used for all analyses; many variable names differ across surveys; BP percentiles rather than cutoffs must be calculated for children <18 years old; no relative standard errors >30% can be reported due to identifiability and reliability issues.
References and Sources:
  • National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Blood Pressure Tbles for Children and Adolescents. Pediatrics. 2004;114(2 Suppl 4th Report):555-76.

Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd