STATISTICAL BRIEF #315: Hypertension in America: Estimates for the U.S. Civilian Noninstitutionalized Population, Age 18 and Older, 2008

STATISTICAL BRIEF #315:
Hypertension in America: Estimates for the U.S. Civilian Noninstitutionalized Population, Age 18 and Older, 2008


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March 2011
William Carroll, MA
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Highlights
■ 25.8 percent or 59.4 million adults were reported to have been told at two or more different health care visits that they have hypertension.
■ The percentage of non-Hispanic blacks ever diagnosed with hypertension was higher than for non-Hispanic whites (31.7 percent versus 26.8 percent), while the percentage among Hispanics was lower than for non-Hispanic whites (18.0 percent versus 26.8 percent).
■ The percentage of overweight to morbidly obese adults ever diagnosed with hypertension was twice that of healthy weight adults (31.4 percent versus 15.2 percent).
■ Among adults 18 to 64 years old, the uninsured were substantially less likely to have ever been diagnosed with hypertension than adults covered only by public health insurance (13.6 percent versus 28.6 percent), or covered by any private health insurance (13.6 percent versus 18.8 percent).


Introduction

Hypertension, commonly referred to as high blood pressure, is a serious medical condition which, if not controlled, can lead to more serious cardiovascular conditions. Lifestyle factors, such as exercise, weight control, and stress reduction, can affect the risk and impact of hypertension. MEPS data show that regular exercise, maintaining a healthy weight, and having a low level of stress are all associated with lower rates of hypertension.

Data from the 2008 Medical Expenditure Panel Survey (MEPS) show that an estimated 25.8 percent of adults 18 years old and older had been told by a health care professional at two or more different medical visits that they had hypertension. An estimated 19.4 percent of adults with hypertension are unaware they have the condition.1

Diagnosed hypertension as reported by household respondents in the MEPS is not distributed evenly across all subgroups of adults. This Brief examines variation in the percentage of adults with diagnosed hypertension by race/ethnicity, age, educational attainment, family income, and insurance status. Adults were classified as having diagnosed hypertension if there was a response of "yes" to a survey question asking whether the adult had been told they had hypertension by a health care professional at two or more different medical visits.

All differences discussed in the text are statistically significant at the p < 0.05 level.
Findings
25.8 percent or 59.4 million adults were reported to have been told at two or more different health care visits that they have hypertension.

Demographic and socioeconomic characteristics (see figures 1 and 2)

In 2008, there was no significant difference by gender in the proportion of adults who had ever been diagnosed with hypertension (about one-quarter of both women and men) (figure 1). However, the percentage of adults ever diagnosed with hypertension did vary across various race/ethnic groups and by age. The percentage was higher among non-Hispanic black adults (31.7 percent) compared to non-Hispanic white adults (26.8 percent), while the rate among Hispanics (18.0 percent) was lower than that of non-Hispanic whites and non-Hispanic blacks. A positive relationship existed between diagnosed hypertension and age (2.7 percent among persons 18-24 years old and 58.9 percent among persons 65 years and older).
The percentage of adults ever diagnosed with hypertension also differed according to selected socioeconomic characteristics (figure 2). The percentage among adults with less than a high school education was about 30 percent greater than for adults with a college education (28.4 percent versus 21.3 percent, respectively). Differences also existed by income (29.6 percent among low income adults versus 23.8 percent among high income adults).

Health insurance status (see figure 3)

Among adults 18 to 64 years old, the likelihood of ever being diagnosed with hypertension was lowest among uninsured adults (13.6 percent) and highest among those covered only by public insurance (28.6 percent). The rate for adults with any private health insurance was in between (18.8 percent).

When comparing the insured to the uninsured figure 3 shows that for young adults there was no difference in the percent with diagnosed hypertension, however uninsured adults 25 years old and older were less likely to have hypertension.

Lifestyle factors (see figure 4)

Healthy lifestyles can help reduce the risk and impact of hypertension. Figure 4 shows that the percentage of adults ever diagnosed with hypertension increased progressively with increasing body weight (as reported by the household respondent). Specifically, the percentage of overweight adults with diagnosed hypertension was 25.7 percent compared to 15.2 percent among normal weight adults. More striking, however, was the 3.3 times higher percentage of morbidly obese adults ever diagnosed with hypertension compared to normal weight adults (50.5 percent versus 15.2 percent, respectively). About 62 percent of the adults with diagnosed hypertension that were overweight, obese, or morbidly obese were advised by a health professional to eat fewer high fat or high cholesterol foods (data not shown in figure).

The percentage of adults ever diagnosed with hypertension also varied by exercise activity and stress level. The percentage among adults who reported that they spent half an hour or more in moderate or vigorous physical activity at least three times a week was lower than among persons not reporting this level of exercise activity (20.6 percent and 32.2 percent, respectively). About 59 percent of the adults with hypertension were advised by a health professional to exercise more (data not shown in figure). Regarding stress, 24.6 percent of adults who reported that they felt calm all or most of the time had been diagnosed with hypertension compared to 28.6 percent of adults that reported feeling calm only some, little or none of the time.

Considering the above lifestyle factors together, 13.9 percent of all adults reported that they exercised regularly, had a normal weight, and felt calm all or most of the time. Among these lower risk persons, about 12.3 percent had hypertension compared to 28.3 percent of the rest of the adult population (data not shown in figure).

The 2008 MEPS data also show that 17.7 percent of adults who had ever been diagnosed with hypertension were current smokers and that about 67.6 percent of those had been advised by a doctor to quit smoking within the past 12 months (data not shown in figure).


Data Source

The estimates shown in this Statistical Brief are drawn from MEPS public use file, MEPS HC-121: 2008 Full Year Consolidated Data File.

Definitions
see the original article

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STATISTICAL BRIEF #315: Hypertension in America: Estimates for the U.S. Civilian Noninstitutionalized Population, Age 18 and Older, 2008