The prevalence of hypertension in U.S. adults ranged from 14% to 41% in 2013-2014, depending on the definition; 41% either reported having hypertension or having a measured blood pressure ≥140/≥90 mmHg.
From 1999 to 2014, prevalence of hypertension by either self-report or measured blood pressure ≥140/≥90 mmHg in the U.S. adult population had a significant increasing trend (P<0.001) over time.
In 2013-2014, 35.0% of U.S. adult participants self-reported having hypertension, while hypertension was reported for 15.0% of participants with measured blood pressure levels ≥140/≥90 mmHg. A total of 28.8% reported having a prescription for hypertension medication. Overall, 40.5% of participants had hypertension by the main definition of either self-report or measured blood pressure of ≥140/≥90 mmHg.
Prevalence of hypertension in the U.S. adult population significantly increased in a linear trend (P
<0.001) from 1999 to 2014. This representing a 16.6% increase from the 1999-2000 prevalence (34.8%).
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 CKD. Hypertensive disease accounts for 28% of incident ESRD in the United States (U.S. 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 NHANES surveys are currently conducted every 2 years by the CDC's National Center for Health Statistics to examine disease prevalence and trends over time in different cross-sectional representative samples of 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, 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|