The prevalence of hypertension by self-report or measured blood pressure ≥140/≥90 mmHg in the U.S. adult population was highest in people aged 60 to 69 years or 70+ years (71-85% vs. 18% in 20- to 39-year-olds); non-Hispanic black (52% vs. 47% and 30% for white and Mexican-American, respectively), or those with obesity (56% for BMI ≥ 30 vs. 36% for BMI <30 kg/m²).
Chart Explanation: The crude prevalence of hypertension among U.S. adults was consistently highest in the oldest participants in 1999 through 2014. Specifically in 2013-2014, 71.1% (aged 60 to 69) and 84.7% (aged 70+) reported having hypertension while 17.8% of the youngest participants (aged 20 to 39) reported having hypertension. The prevalence of hypertension was not very different by gender, with male and females both having a crude prevalence of 44%. In 2013-2014, non-Hispanic blacks (51.9%) had a higher crude prevalence than whites (46.7%) and Mexican-Americans (30.4%), which was the same pattern for all years prior. Crude prevalence of hypertension was much greater in adults with obesity at 55.8%, compared with a prevalence of 36.2% in those without obesity, with this prevalence having remained about the same over the past 16 years.
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 angiotensin-converting enzyme (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|
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.