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Indicator Details: Trends in Hypertension Diagnosis, Treatment, and Control Among Us Veterans
Data Sources
 
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  Source
  • NATIONAL VA

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  • Year, Hypertension Status
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From 2006 to 2018, about 94% of US Veterans with CKD and high blood pressure had a diagnosis of hypertension, the percentage of Veterans with diagnosed hypertension and treatment with BP-lowering medications but not controlled BP (BP > 130/80 mm/Hg) declined from 57.6% to 51.3% and achieving BP control (BP ≤ 130/80 mmHg) increased from 30.2% in 2006 to 32.5% in 2010, but then declined to 25.2% in 2018. 

Chart Explanation: 

Among Veterans with CKD and hypertension, the percentage within each stratum is displayed by year. 

The Veteran’s Affairs (VA) data presented are from a national sample of health care visits to the VA Health System by eligible U. S. veterans. During any given year, ~ 70% of the outpatient population receives a serum creatinine test. While the demographics of VA Health System users are distinct from the general U.S. population, the VA data allow a ‘snapshot’ of clinical practices across the nation.

National VA data were examined. For all FY2006-FY2018 analyses were performed on the entire patient population (100% sample).

This material is the result of work supported with resources and the use of facilities at the Veterans Affairs Ann Arbor Health Care System, Ann Arbor, Michigan.

FieldData
Description of Measure

Blood pressure treatment and control from 2006-2018

Data Source

VA

Type of Data Source

Administrative

Data Set

100% National VA data

Health Care System Data

Yes

Demographic Group

Patients in VA health system

Numerator

Patients in the denominator who fall into the following groups: 

“HTN Undiagnosed, Uncontrolled” = High BP measurement without HTN diagnosis or HTN medication

“HTN Diagnosed, Untreated” = Diagnosis of HTN, but no HTN medication

“HTN Diagnosed, Treated, Uncontrolled” = Diagnosis of HTN and taking HTN medication, but BP > 130/80

“HTN Diagnosed, Treated, Controlled” = Diagnosis of HTN, taking HTN medication, and BP ≤ 130/80

HTN = hypertension

Denominator

Patients >20 years old and who had at least 1 outpatient visit in the fiscal year who also have any indication of hypertension AND chronic kidney disease (diagnosis of hypertension, have BP > 130/80, or who are on medication for blood pressure control AND who either have a diagnosis of CKD, eGFR < 60 ml/min/1.73m2, or UACR > 30 mg/g).

Definition of hypertension

Hypertension status determined by ICD-9-CM codes (362.11; 401-405; 437.2) or ICD-10-CM code (H35.031-H35.039, I10-I13.2, I15.0-I15.9, I67.4, N26.2) and/or prescribed antihypertensive medication (outpatient only) and/or BP > 130/80

Primary Data Source Indicators

ICD-9-CM or ICD-10-CM code for hypertension, Blood pressure measurement, Medication for HTN

Primary Indicator Method of Measurement

Medical record

Frequency of Measurement (Primary)

Multiple measurements per patient

U.S. Region Covered by Primary Variable

All

Period Currently Available

2006–2018

Limitations of Indicator

Estimates are limited by health care system testing and patient utilization of health care resources.

References and Sources:

  • United States Renal Data System. 2020 USRDS Annual Data Report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2020.


  • 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.


    https://www.ahajournals.org/doi/10.1161/HYP.0000000000000065

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