Hypertension Statistics for US Adults: An Open-Source Web Application for Analysis and Visualization of National Health and Nutrition Examination Survey Data

Abstract

Background: Data from the US National Health and Nutrition Examination Survey are freely available and can be analyzed to produce hypertension statistics for the noninstitutionalized US population. The analysis of these data requires statistical programming expertise and knowledge of National Health and Nutrition Examination Survey methodology. Methods: We developed a web-based application that provides hypertension statistics for US adults using 10 cycles of National Health and Nutrition Examination Survey data, 1999 to 2000 through 2017 to 2020. We validated the application by reproducing results from prior publications. The application’s interface allows users to estimate crude and age-adjusted means, quantiles, and proportions. Population counts can also be estimated. To demonstrate the application’s capabilities, we estimated hypertension statistics for noninstitutionalized US adults. Results: The estimated mean systolic blood pressure (BP) declined from 123 mm Hg in 1999 to 2000 to 120 mm Hg in 2009 to 2010 and increased to 123 mm Hg in 2017 to 2020. The age-adjusted prevalence of hypertension (ie, systolic BP≥130 mm Hg, diastolic BP≥80 mm Hg or self-reported antihypertensive medication use) was 47.9% in 1999 to 2000, 43.0% in 2009 to 2010, and 44.7% in 2017 to 2020. In 2017 to 2020, an estimated 115.3 million US adults had hypertension. The age-adjusted prevalence of controlled BP, defined by the 2017 American College of Cardiology/American Heart Association BP guideline, among nonpregnant US adults with hypertension was 9.7% in 1999 to 2000, 25.0% in 2013 to 2014, and 21.9% in 2017 to 2020. After age adjustment and among nonpregnant US adults who self-reported taking antihypertensive medication, 27.5%, 48.5%, and 43.0% had controlled BP in 1999 to 2000, 2013 to 2014, and 2017 to 2020, respectively. Conclusions: The application developed in the current study is publicly available and produced valid, transparent, and reproducible results.

Concordance of high blood pressure among middle-aged and older same-sex couples in the USA

“…Finally, although the 2017 ACC/AHA guidelines recommend diagnosis of hypertension based on ≥ 2 readings taken on ≥ 2 visits, only blood pressure measurements from the latest survey were included. 1…”

“…Hypertension affects 115 million adults in the United States (US). 1 Heterosexual couples in romantic relationships are known to influence each other’s hypertension risk (including overweight/obesity) and hypertension status, suggesting couple-focused interventions may be beneficial for long-term disease management. 2 However, the role of partners on an individual’s hypertension status in same-sex relationships is less understood, despite substantial health disparities for sexual minorities relative to the general population.…”

Trends difference in prevalence of hypertension subtypes and hypertension control in US adults as defined by 2017 ACC/AHA Guideline and 2003 JNC7 Guideline

“…Second, some estimates, including taking antihypertensive medication, CVD history and part of diabetes, were derived from participant self-report, and the possibilities of reporting or recall bias may not be excluded. Third, the present study did not account for masked and whitecoat hypertension as data on medication adherence and ambulatory BP monitoring were not collecting by NHANES 23,24 . Fourth, the association of lifestyle factors including diet and physical exercise with BP control was not analyzed in this study.…”

Machine learning models for blood pressure phenotypes combining multiple polygenic risk scores

“…Blood pressure (BP) is highly polygenic and, when elevated, is one of the primary risk factors for the development of several cardiovascular diseases such as coronary artery disease and stroke [18,19]. Nearly half of the adults in the U.S have hypertension [20], with higher prevalence among adults who are Black, compared to other subgroups [21,22]. PRSs have been developed to predict BP phenotypes across the lifespan [23][24][25][26].…”