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Methodological choices in age adjustment can artificially lower reported rates of hypertension awareness and control, highlighting the importance of selecting an appropriate standard population.
A 1982 report from the National Center for Health Statistics presents rates of awareness, treatment, and control among US adult hypertensives. These rates are age-adjusted by the direct method to permit comparisons among three surveys of US adults conducted over 20 years. The choice of a standard population for the age adjustment, however, results in a systematic decrease in the adjusted rates for awareness, treatment, and control. This decrease leads the casual reader of this often quoted report to conclude that awareness, treatment, and control of hypertension are worse than they actually are. An alternative choice for the standard population is suggested when the inference population is hypertensives rather than the general population.
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Brogan et al. (1986) studied this question.
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