With adjustment for age, prevalence of hypertension by self-report or measured blood pressure ≥140/≥90 mmHg in the U.S. adult population was highest in non-Hispanic blacks (55% vs. 44% and 38% for whites and Mexican-Americans, respectively), and as well in adults with obesity (54% for BMI ≥ 30 vs. 36% for BMI <30 kg/m²).
With adjustment for age, prevalence of hypertension by self-report, hypertension medication, or measured blood pressure ≥140/≥90 mmHg in the U.S. adult population was 42.5% in 2013-2014. In 1999-2000 to 2011-2012, there was no statistical significant increase in adults with hypertension over time.
Chart Explanation: The age-adjusted prevalence of hypertension among adults during 1999 to 2014 was not dramatically different by gender. In 1999 to 2000, the prevalence was slightly higher in females (50.0%) than in males (38.0%), but changed with times to males having a slightly higher adjusted prevalence of 44.5% compared with 42.4% in females during 2013-2014. Non-Hispanic blacks consistnetly had a higher prevalence of hypertension throughout the 16 years. In 2013-2014, non-hispanic blacks had an age-adjusted prevalence of 54.5%, which was higher than than whites (39.5%) and Mexican-Americans (36.6%). Age-adjusted prevalence remained relatively the same throughout all years, but was highest in those who with obesity (54.3%), compared to those who did not have obesity 34.1%.
The age-adjusted prevalence of hypertension as defined by self-report, hypertension medication, or measured blood pressure ≥140/≥90 mmHg in the U.S. adult population significantly increased in 1999-2000 to 2013-2014. Specifically, a 10% increase was observed between the prevalence of hypertension in 1999-2000 (38.6%) to 2013-2014 (42.5%), however this was not significant.
The National Health and Nutrition Examination Survey (NHANES) is a nationally representative, cross-sectional survey that is currently conducted every 2 years by the Centers for Disease Control and Prevention's National Center for Health Statistics to examine disease prevalence and trends over time in noninstitutionalized U.S. civilian residents.
Hypertension is the second leading cause of chronic kidney disease (CKD). Hypertensive disease accounts for 28% of incident end-stage renal disease (ESRD) in the United States (United States Renal Data System, 2011
). Hypertension is associated with higher risk of cardiovascular outcomes in those with CKD. Additionally, treatment of hypertension in CKD, particularly by ACE inhibitors, has been shown to decrease proteinuria and disease progression (Sarafidis et al., 2008). Thus, assessing the prevalence of this risk factor and its control is essential to CKD surveillance. 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, and 2013-2014 NHANES. Self-reported hypertension was defined by answer of “yes” to the question, “Have you ever been told by a doctor or other health professional that you have hypertension, or high blood pressure?” Blood pressure measurements were taken by standardized protocol during the MEC and the average value (up to four measurements) was used. Hypertension medications were recorded from prescription bottles during the interview.
|Description of Measure||Prevalence of hypertension and blood pressure control in the general adult population|
|Type of Data Source||Public|
|Health Care System Data||No|
|Regional or National?||National|
|Demographic Group||Non-institutionalized U.S. residents aged 8+ years|
|Numerator||Participants with self-report or high (≥140/≥90) blood pressure measurements (or hypertension drug use; treatment and awareness only)|
|Denominator||Participants with completed surveys or blood pressure measurements (or drug information; treatment, awareness, control only)|
|Primary Data Source Indicator||bpq020: “Have you ever been told by a doctor or health professional that you have high blood pressure?” yes/no|
|Primary Indicator Method of Measurement||Questionnaire (interviewer-administered); ages 16+|
|Secondary (1) Variable||bpxsy1-bpxsy4: Up to four blood pressure measurements|
|Secondary (1) Indicator Method of Measurement||Examination/Laboratory|
|Secondary (2) Variable||nhcode/rxddrgid: generic drug codes|
|Secondary (2) Indicator Method of Measurement||Questionnaire (interviewer-administered), with recording of medications from Rx bottles|
|Frequency of Measurement (Primary)||Once (cross-sectional)|
|U.S. Region Covered by Primary Variable||All|
|Period Currently Available||1999–2014|
|Additional Data Items of Interest||Stage of CKD, stratification variables of interest (age, gender, race/ethnicity, BMI, hypertension by self-report)|
|Limitations of Indicator||Blood pressure in age 8+ only; interview in age 16+ only|
|Analytic Considerations||Appropriate NHANES survey weights must be used for all analyses; many variable names differ across surveys; awareness: self-report within the treated/high BP population; treatment: drug use within the treated/high BP population|
|Age Adjustment||Adjusted for the distribution of age within the sample.|
References and Sources:
Sarafidis PA, Li S, Chen SC, et al. Hypertension awareness, treatment, and control in chronic kidney disease. Am J Med. 2008;121(4):332-40.
National Institute of Diabetes and Digestive and Kidney Diseases. USRDS 2011 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, Bethesda, MD: National Institutes of Health; 2011.