The fraction of patients meeting our definition of hypertension increases with age from 9%-15% for ages 20-29, 22%-25% for ages 30-39 and 39%-42% for ages 40-49.
Chart Explanation: The chart shows on the y-axis (vertical line) the percentage of patients with diagnosis of hypertension. The x-axis (horizontal line) shows the age groups (the block of bars) by year, gender, or race/ethnicity (the individual colored bars).
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 veterans with at least one outpatient visit during the federal fiscal year. To estimate prevalence of CKD, outpatient serum creatinine laboratory results (averaged if a patient had more than one test during the fiscal year) were used to calculate an estimated glomerular filtration rate (eGFR) for each patient using the CKD-EPI equation, excluding dialysis and transplant patients. Estimated GFR (kidney function) was classified into five CKD categories (eGFR =90, eGFR 60-89, stage 3=eGFR 30-59, stage 4=eGFR 15 to 29, and stage 5 without dialysis=eGFR<15 ml/min/1.73 m² and “eGFR Unmeasured” for those patients without serum creatinine testing. Inpatient serum creatinine data were not used as they would be affected by the presence of acute illnesses. Due to the infrequency of testing, albuminuria was not included in the definition of CKD. Dialysis patients were defined by clinic stop-codes (602-611), outpatient procedure codes for dialysis (CPT4: 90921 and 90925), outpatient diagnosis codes (ICD-9-CM: 585.6, V56, V45.1 and E87.91 and ICD-10-CM: N186, Y841, Z4931, Z4901, Z4902, Z4931, Z4932, and Z4933) to indicate dialysis. Kidney transplant patients were identified by inpatient and outpatient ICD-9-CM diagnosis code V420, 99681, ICD-10 CM diagnosis code T86X, Z4822 and Z940, and inpatient procedure and surgery codes (55.69)
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.
|Description of Measure||Hypertension as a risk factor for CKD|
|Type of Data Source||Administrative|
|Data Set||VA National Data, using the MedSAS data files|
|Health Care System Data||Yes|
|Regional or National?||National|
|Demographic Group||Patients in VA health system|
|Numerator||Patients in denominator with diagnosis of hypertension or who are on medication for blood pressure control.|
|Denominator||Patients >20 years old and who had at least 1 outpatient visit in the fiscal year.|
|Definition of hypertension||Hypertension status determined by ICD-9-CM/ICD-10-CM code and/or prescribed antihypertensive medication (outpatient only).|
|Primary Data Source Indicator||ICD-9-CM code for hypertension|
|Primary Indicator Method of Measurement||Medical record|
|Secondary (1) Variable||Age = (Date of Visit - Date of Birth)/365.25|
|Secondary (1) Indicator Method of Measurement||Outpatient Visit|
|Secondary (2) Variable||Gender: Sex|
|Secondary (2) Indicator Method of Measurement||Outpatient Visit|
|Frequency of Measurement (Primary)||Multiple measurements per patient|
|U.S. Region Covered by Primary Variable||All|
|Period Currently Available||2005–2018|
|Limitations of Indicator||Prevalence estimation limited by health care system testing and patient utilization of health care resources.|
|Analytical Considerations||Coding of medications in the VA system changed in 2009, differences in prevalence calculations may not be due to true changes in underlying population.|