Including the nontraditional definition of hypertension increased prevalent hypertension estimates to 31.8% vs 28.7% and hypertension control rates to 56.5% vs 51.8% in the 2007-2010 NHANES.
Cross-Sectional
How does the inclusion of a nontraditional definition of hypertension impact prevalent hypertension estimates and the attainment of Healthy People goals?
Including a nontraditional definition of hypertension significantly increases prevalent hypertension estimates and apparent control rates, impacting the perceived attainment of national public health goals.
Absolute Event Rate: 56.5% vs 51.8%
Prevalent hypertension in National Health and Nutrition Examination Surveys (NHANES) is traditionally defined as blood pressure (BP) ≥140 mm Hg systolic and/or ≥90 diastolic and/or currently taking antihypertensive medications. When estimating prevalent hypertension, American Heart Association (AHA) statistical updates include the traditional definition of hypertension (tHTN) and untreated individuals with nonhypertensive BP told twice that they were hypertensive (nontraditional ntHTN). The characteristics of ntHTN and their impact on the clinical epidemiology of hypertension and Healthy People prevention and control goals are undefined. NHANES 1999-2002, 2003-2006, and 2007-2010 were analyzed. The ntHTN group was younger and had less diabetes and lower BP than the tHTN group but higher BP than the normotensive group. When classifying ntHTN as hypertensive, prevalent hypertension increased approximately 3% and control 5% to 6% across NHANES periods. In 2007-2010, the Healthy People 2010 goal of controlling BP in 50% of all hypertensive patientss was attained when ntHTN was classified as hypertension (56.5% 95% confidence interval (CI), 54.2-58.7) and nonhypertension (51.8% 95% CI, 49.6-53.9). When including ntHTN in prevalent hypertension estimates, the Healthy People 2020 goal of controlling BP in 60% of hypertensive patients becomes more attainable, whereas reducing prevalent hypertension to 26.9% (31.8% 95% CI, 30.5-33.1) vs 28.7% 95% CI, 27.5-30.0) becomes more challenging.
Egan et al. (Wed,) conducted a cross-sectional in Hypertension. Nontraditional definition of hypertension (ntHTN) vs. Traditional definition of hypertension (tHTN) was evaluated on Hypertension control rate in 2007-2010. Including the nontraditional definition of hypertension increased prevalent hypertension estimates to 31.8% vs 28.7% and hypertension control rates to 56.5% vs 51.8% in the 2007-2010 NHANES.