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The Impact of Differences in Methodology and Population Characteristics on the Prevalence of Hypertension in US Adults in 1976-1980 and 1999-2002

Citation

Wright, Jacqueline D.; Stevens, June; Poole, Charles L.; Flegal, Katherine M.; & Suchindran, Chirayath M. (2010). The Impact of Differences in Methodology and Population Characteristics on the Prevalence of Hypertension in US Adults in 1976-1980 and 1999-2002. American Journal of Hypertension, 23(6), 620-626. PMCID: PMC5774853

Abstract

Background: Results from the National Health and Nutrition Examination Survey (NHANES) indicate that hypertension prevalence declined by 9% points from 34% in 1976-1980 to 25% in 1999-2002 in adults 20-74 years. The purpose of this study was to estimate the impact on hypertension prevalence of measurement error and selected risk factors.
Methods: Using cross-sectional survey data from NHANES, we estimated the effect on hypertension of incorrect blood pressure (BP) cuff size and zero end-digit preference and the effect of changes in the distribution of age, body mass index (BMI), sex, race-ethnicity, smoking, and education. The analytic sample of persons 20-74 years consisted of 11,563 from 1976-1980 and 7,901 from 1999-2002 NHANES. Covariate-adjusted prevalences were calculated using log-linear regression models to produce predictive margins.
Results: After adjustment to age, BMI, sex, race-ethnicity, smoking, and education, the prevalence difference became higher, changing from -9% (95% confidence interval (CI): -11, -6) to -14% (95 CI: -17, -11). After adjustment to these risk factors and correction for measurement error the prevalence difference was -9% (95 CI: -11, -6).
Conclusions: Measurement error, mainly from cuff size differences, inflated the temporal decline in hypertension prevalence. The results indicate that age, sex, race-ethnicity, smoking, or education did not fully explain the lower prevalence of measured hypertension in all BMI groups and suggest that a change in some unmeasured factor or factors contributed to the decline.

URL

http://dx.doi.org/10.1038/ajh.2010.40

Reference Type

Journal Article

Year Published

2010

Journal Title

American Journal of Hypertension

Author(s)

Wright, Jacqueline D.
Stevens, June
Poole, Charles L.
Flegal, Katherine M.
Suchindran, Chirayath M.

PMCID

PMC5774853