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Indicator Details: Crude Percentage Reporting Having Hypertension
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  • NHANES

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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 (66-84% vs. 19% in 20- to 39-year-olds); non-Hispanic black (52% vs. 47% and 31% for white and Mexican-American, respectively), or those with obesity (56% for BMI ≥ 30 vs. 36% for BMI <30 kg/m²).

Chart Explanation: 

The prevalence of hypertension among U.S. adults was consistently highest in the oldest participants in 1999 through 2018 and lowest for those in the 20-39 age group. The prevalence of hypertension in males was higher at 48%, while in females was 42%. In 2017-2018, non-Hispanic blacks (52.1%) had a higher crude prevalence than whites (46.7%) and Mexican-Americans (31.3%), which was the same pattern for all years prior. Crude prevalence of hypertension was much greater in adults with obesity at 55.6%, compared with a prevalence of 36.4% in those without obesity, with this prevalence having remained about the same over the 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, 2013-2014, 2015-2016, and 2017-2018 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 Group

Noninstitutionalized U.S. residents aged 20+ years

Numerator

Nonpregnant participants with self-report or high (≥140/≥90) blood pressure measurements or hypertension drug use

Denominator

Nonpregnant participants with completed surveys or blood pressure measurements or drug information

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) Variable

bpxsy1-bpxsy4 and bpxdi1-bpxdi4 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 Available

1999–2018

Pending Data

2019-2020

Additional Data Items of Interest

stratification variables of interest (age, gender, race/ethnicity, BMI)

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