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Indicator Details: Percentage with Hypertension Awareness, Treatment, and Controla
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  • NHANES

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  • Year, Awareness
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Footnotes:
a Awareness = participant had high measured blood pressure or used hypertension medications and reported hypertension diagnosis; treatment = participant had high measured blood pressure or used hypertension medications and were treated with hypertension medications); and control = participant was treated with hypertension medication and had measured blood pressure <140/<90 mmHg.




About three-quarters (77%) of adults with hypertension were aware of their disease in 2013-2014; more than half were treated for hypertension with medications (64%); and almost a quarter were at controlled levels with these medicines (73% with blood pressure <140/<90 mmHg).

Chart Explanation: Of those who had hypertension by either measured blood pressure or reported used of hypertensive medication, 77.3% were aware of their condition in 2013-2014. More than half (63.9%) of those participants who had measured blood pressure levels ≥140/ ≥90 mmHg were being treated for their condition through medication. Among participants with hypertension, who were being treated for their condition with medication, 73.2% had their condition under control with measured blood pressure levels <140/ <90 mmHg. A statistically significant increasing trend (p<0.001) was observed for all three groups across the years 1999 to 2014.
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 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.
FieldData
Description of MeasurePrevalence of hypertension and blood pressure control in the general adult population
Data SourceNCHS
Type of Data SourcePublic
Data SetNHANES
Health Care System DataNo
Regional or National?National
Demographic GroupNon-institutionalized U.S. residents aged 8+ years
NumeratorParticipants with self-report or high (≥140/≥90) blood pressure measurements (or hypertension drug use; treatment and awareness only)
DenominatorParticipants with completed surveys or blood pressure measurements (or drug information; treatment, awareness, control only)
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 Available1999–2014
Pending Data2015-2016
Additional Data Items of InterestStage of CKD, stratification 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; awareness: self-report within the treated/high BP population; treatment: drug use within the treated/high BP population
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.
    http://www.ncbi.nlm.nih.gov/pubmed/18374693
  • 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.
    https://www.usrds.org/reference.aspx
Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd