Background:
Geographic disparities have been reported in prevalence, awareness, and treatment of hypertension. Several community-based national surveillance systems assess hypertension allowing for comparison of estimates. The objectives of this study were to compare hypertension estimates across surveys and to examine geographic differences in the findings.
Methods:
Using data from the National Health and Nutrition Examination Survey (NHANES) 2007-2010, the National Health Interview Survey (NHIS) 2008, and the Behavioral Risk Factor Surveillance Survey (BRFSS) 2009, we calculated prevalence estimates of measured hypertension (an average systolic BP ≥140 mm Hg or an average diastolic BP ≥90 mm Hg or self-reported current use of BP-lowering medication), self-reported hypertension (having ever been told that one has hypertension), and treatment, nationally and regionally.
Results:
Nationally, 30.5% of adults have hypertension with higher prevalence in the Midwest (33.0%) and South (32.6%) and lower prevalence in the West (26.0%) and Northeast (28.0%) (NHANES). In all surveys, self-reported hypertension was highest in the South (range: 31.1% [NHIS] - 32.8% [NHANES],) and lowest in the West (range: 23.6% [NHIS] - 27.0% [BRFSS]). In all surveys and all regions, more than two-thirds of participants who were aware of their high blood pressure reported receiving treatment. Treatment prevalence was lowest in the West (range: 69.7% [NHIS] - 74.5% [BRFSS]), highest in the South in NHIS (77.5%) and BRFSS (81.4%), and highest in the Northeast in NHANES (78.3%).
Conclusions:
Similar estimates showing regional differences in measured and self-reported hypertension and treatment were found across all three national surveys. In addition, low treatment has been identified in regions with low prevalence. As recognized in many national initiatives (e.g., Million Hearts), improving hypertension treatment and control requires multi-level interventions across community and clinical settings.
