Questions for Ryne Paulose, NHANES’ Associate Director for Science and Lead Author of “Characteristics of Adults with Hypertension who are Unaware of their Hypertension, NHANES 2011–2014”
Q: What made you want to do a report on adults with hypertension who are unaware of their hypertension?
RP: We have a number of NCHS brief reports on prevalence of hypertension, awareness, control, and treatment. We wanted to publish a brief report that further characterizes adults who are unaware of their hypertension. Being undiagnosed and unaware of having hypertension is a problem since these blood pressure for these adults will remain above normal levels and have potentially damaging effects.
Q: It looks there was a major decline in the number of adults with hypertension that were unaware they had it since 1999-2002 data? Do you know why there has been a significant decline?
RP: Yes, there was a 46% decline from 1999-2002 to 2011-2014, in the percent of adults with hypertension who were unaware. The decline was seen across all age groups. But the decline was greater for those 60 years and older.
We did not specifically examine reasons for the decline in this brief report. But in our report, we do see that the percent unware was lower among adults with health insurance or with increased healthcare visits in the prior year. This implies that increased contact with a healthcare provider increases the chances that high blood pressure will be identified and diagnosed.
Q: Were there major differences in income and education level among adults with hypertension who were unaware of their hypertension?
RP: Generally, there were no differences by income or education level in the percent of adults with hypertension who were unaware. About 14-18% of adults at different income levels were unaware and about 14-19% of adults at different education levels were unaware.
Q: Was there anything in your report that surprised you?
RP: The oversampling of Asian Americans in NHANES is new as of 2011. So, the estimates for Non-Hispanic Asians was an unknown from earlier years. So, the differences we reported did surprise me. Further analysis is in progress to better understand these differences.
Q: What is the take home message from this report?
RP: Although we’ve seen a significant decline in the percent of adults with hypertension who were unaware of their hypertension, nearly 1 in 6 adults with hypertension is unaware of his/her hypertension. Additional efforts may be needed to identify and diagnose these individuals for management and control of their high blood pressure.
CDC’s National Center for Health Statistics has updated its “Stats of the States” feature on the NCHS web site. This resource features the latest state-by-state comparisons on key health indicators ranging from birth topics such as teen births and cesarean deliveries to leading causes of death and health insurance coverage.
Tabs have been added to the color-coded maps to compare trends on these topics between the most recent years (2015 and 2014) and going back a decade (2005) and in some cases further back.
To access the main “Stats of the States” page, use the following link:
Age Differences in Visits to Office-based Physicians by Adults with Hypertension: United States, 2013November 17, 2016
Questions for Jill J. Ashman, Ph.D., Health Statistician and Lead Author on “Age Differences in Visits to Office-based Physicians by Adults With Hypertension: United States, 2013”
Q: Why did you choose age differences as the demographic focus of your study?
JA: I wanted to examine this demographic because of the dramatic differences by age I was seeing in preliminary analyses. For instance, the increase by age in the percentage of adult visits to office-based physicians made by adults with hypertension is large–going from 9% of adults aged 18-44 to 58% of adults aged 75 and over.
Q: What do you think is the most significant finding in your new study?
JA: Probably, the most significant finding is that 34% of all adult visits to office-based physicians were made by adults with hypertension, representing an estimated 259 million office visits in 2013.
Q: How likely was it that medication(s) for high blood pressure were included as part of the treatment that Americans with hypertension were getting at their doctors’ offices?
JA: VERY LIKELY! Hypertensive medications were provided, prescribed, or continued at 62% of office-based physician visits made by adults with hypertension, and the percentage with hypertensive medications increased with age. Half of visits by patients aged 18-44 with hypertension included hypertensive medications whereas this percentage increased to 65% for visits by patients aged 75 and over with hypertension.
Q: Among American adults with high blood pressure, is hypertension the only condition they have when they visit their doctors’ offices?
JA: Hypertension is NOT their only health concern. Eighty-two percent of visits in 2013 that were made by adults with hypertension were made by patients who had been diagnosed with other chronic conditions. A quarter of the visits by adults with hypertension were made by patients who had been diagnosed with 4 or more chronic conditions.
Q: What is the take home message of your report?
JA: I think it’s important to note that regardless of age, adults with hypertension use extensive health resources as evidenced by frequent visits to the doctor (47% of all such visits including four or more visits to the same doctor in the past year) and that there is extensive use of hypertensive medications, with 62% of all such visits including one or more hypertensive medications.
An NCHS report presents updated estimates for the prevalence and control of hypertension in the United States for 2011–2014.
- Prevalence of hypertension among adults was 29.0% in 2011–2014 and increased with age: 18–39, 7.3%; 40–59, 32.2%; and 60 and over, 64.9%.
- Hypertension prevalence was higher among non-Hispanic black (41.2%) than non-Hispanic white (28.0%), non-Hispanic Asian (24.9%), or Hispanic (25.9%) adults.
- Prevalence of controlled hypertension was 53.0%, and adults aged 18–39 were less likely to have controlled hypertension than those aged 60 and over.
- Overall, prevalence of controlled hypertension was higher among non-Hispanic white (55.7%) than non-Hispanic black (48.5%), non-Hispanic Asian (43.5%), or Hispanic (47.4%) adults.
- From 1999 to 2014, hypertension prevalence was unchanged, but control of hypertension increased.
A new report from NCHS shows that hypertension affects almost one-third of the U.S. adult population. In 2009–2010, nearly 82% of adults with hypertension were aware of their status, and nearly 76% were taking medication. Despite considerable improvement in increasing the awareness, treatment, and control of hypertension, undiagnosed and uncontrolled hypertension among minority groups remains a challenge. This report presents survey results for 2011–2012 on the prevalence, awareness, treatment, and control of hypertension.
Key Findings From the Report:
- The age-adjusted prevalence of hypertension among U.S. adults aged 18 and over was 29.1% in 2011–2012, similar to the prevalence in 2009–2010.
- The prevalence of hypertension was similar for men and women at nearly one-third. The prevalence increased with age and was highest among older adults; it was also highest among non-Hispanic black adults, at approximately 42%.
- Among adults with hypertension, nearly 83% were aware, nearly 76% were taking medication to lower their blood pressure, and nearly 52% were controlled. There was no change in awareness, treatment, and control from 2009–2010 to 2011–2012.
- Controlled hypertension was similar across race and Hispanic origin groups, but the percentage controlled was higher for women and older adults.