Definitions – Blood Pressure Status

Definitions

Hypertensive:
Systolic blood pressure greater than or equal to 140 mmHg or diastolic blood pressure greater than or equal to 90 mmHg or currently taking prescribed medicine to lower high blood pressure or having been previously told, at least twice, by a physician or other health professional that one has high blood pressure (1), (2).

Prehypertensive:
Systolic blood pressure between 120 mmHg and 139 mmHg or diastolic blood pressure between 80 mmHg and 89 mmHg (2).

Normotensive:
Systolic blood pressure less than 120 mmHg and diastolic blood pressure less than 80 mmHg (2).

Hypertension Awareness:
Among adults with hypertension, an affirmative response to the question, “Have you ever been told by a doctor or health professional that you had hypertension, also called high blood pressure?” (3).

Hypertension Treatment:
Among adults with hypertension, an affirmative response to the question, “Are you now taking prescribed medicine?” (3).

Hypertension Control:
Systolic blood pressure less than 140 mmHg and diastolic blood pressure less than 90 mmHg among those with hypertension (2). Estimates are age-adjusted among persons with hypertension (4).

Race/Ethnicity

Hispanic designation to Race/Ethnicity represents Mexican-Americans up through 2006. After a sampling redesign in 2007, Hispanic designation includes all Hispanics. More details on survey design changes and analytic note can be found in Analytic Note Regarding 2007-2010 Survey Design Changes and Combining Data Across other Survey Cycles pdf.

Non-Hispanic Asians are reported separately only from 2011-12. Non-Hispanic Asians were included in the “Other” category in 2009-10.

Data Source and Methods

Data from the National Health and Nutrition Examination Surveys (NHANES) 1999-2018 are used for these visualizations. For smaller sub-populations the estimates are based on 4 years of data (two cycles merged) for statistical stability. Estimates are age-adjusted to the subpopulations based on the population distribution as of 2000 census.

NHANES is a cross-sectional survey designed to monitor the health and nutritional status of the civilian noninstitutionalized U.S. population using highly stratified, multistage probability designs. The survey consists of interviews conducted in participants’ homes and standardized health examinations conducted in mobile examination centers (MECs). The sample includes nonpregnant persons aged 20 and over (5). Blood pressure was measured in the MEC by trained physicians using standard protocol. All blood pressure readings were obtained during a single examination visit. After a 5-minute rest in a seated position, participants had up to three brachial systolic and diastolic blood pressure measurements taken 30 seconds apart. An average of up to three systolic and diastolic blood pressure readings was used for systolic and diastolic blood pressure values (6).

Hispanic designation to Race/Ethnicity represents Mexican-Americans up through 2006. After a sampling redesign in 2007, Hispanic designation includes all Hispanics. Non-Hispanic Asians are reported separately only from 2011-12. Non-Hispanic Asians were included in the “Other” category in 2009-10. More details on survey design changes and analytic note can be found in Analytic Note Regarding 2007-2010 Survey Design Changes and Combining Data Across other Survey Cycles pdf.

For more information about the National Health and Nutrition Examination Survey, you may visit the NHANES website: http://www.cdc.gov/nhanes.

Reference
  1. Emilia J. Benjamin, et.al. Heart Disease and Stroke Statistics—2018 Update: A Report from the American Heart Association. Circulation. 2018;CIR.0000000000000558.[]
  2. National Heart Lung and Blood Institute. National high blood pressure education program. 2003.[][][][]
  3. Hales CM, Carroll MD, Simon PA, Kuo T, Ogden CL. Hypertension Prevalence, Awareness, Treatment, and Control Among Adults Aged ≥18 Years – Los Angeles County, 1999–2006 and 2007–2014. MMWR Morb Mortal Wkly Rep 2017; 66:846–849.[][]
  4. Crim MT, Yoon SS, Ortiz E, Wall HK, Schober S, Gillespie C, et al. National surveillance definitions for hypertension prevalence and control among adults. Circ Cardiovasc Qual Outcomes 5(3):343–51. 2012.[]
  5. Fryar CD, Ostchega Y, Hales CM, Zhang G, Kruszon-Moran D. Hypertension prevalence and control among adults: United States, 2015–2016. NCHS data brief, no 289. Hyattsville, MD: National Center for Health Statistics. 2017.[]
  6. National Center for Health Statistics. National Health and Nutrition Examination Survey (NHANES): Examination manuals 1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011–2012, 2013–2014, 2015-2016.[]