Health Indicator Report of Blood Pressure: Doctor-diagnosed Hypertension
High blood pressure (hypertension) is an important risk factor for heart disease and stroke. It is preventable, and in most cases it can be treated with medication and lifestyle changes, such as diet, exercise, and tobacco cessation. Treatment works best when high blood pressure is identified early. Because high blood pressure does not produce symptoms, regular screening is recommended.
The rate of hypertension among Utah adults was significantly lower than the rate for U.S. adults (25.1% vs. 30.0%) in 2015.
Doctor-diagnosed Hypertension, Utah and U.S., 1995-2015
NotesDoctor-diagnosed hypertension is based on the answer to the question: "Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure?" Response options are "Yes", "No", and "Yes but female told only during pregnancy, and "Told borderline high or pre-hypertensive." Women who report having hypertension only during pregnancy and individuals who are told they are borderline high are considered as having answered "No." In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change. [[br]] [[br]] Age-adjusted to the 2000 U.S. population. [[br]] [[br]] Note: At the time of this update, the BRFSS U.S. dataset did not include an age variable but did include five age categories up to age 80+ (vs. the typical weighting scheme that includes 85+). Comparisons with both weighting schemes were compared using Utah data, and the difference was about 1/100 of a percentage point. [[br]] [[br]] Beginning in 2011, BRFSS data include both landline and cell phone respondent data along with a new weighting methodology called iterative proportional fitting, or raking. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].
- Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health
- U.S. Data: Behavioral Risk Factor Surveillance System (BRFSS), Division of Behavioral Surveillance, CDC Office of Surveillance, Epidemiology, and Laboratory Services
Data Interpretation IssuesIn order to be accurately diagnosed with hypertension a patient must have had a blood pressure reading of more than 140/90 on two separate visits. The questionnaire does not capture whether a patient was told they had high blood pressure on a single visit or whether they were actually diagnosed with hypertension. To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. In 2010, it began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].
DefinitionThe proportion of adults who have ever been told by a doctor, nurse, or other health professional that they have high blood pressure. High blood pressure is defined as a systolic (upper) number of 140 or greater and a diastolic (lower) number of 90 or greater. This indicator is used to estimate prevalence of high blood pressure in Utah.
NumeratorThe number of survey respondents who have ever been told by a doctor, nurse, or other health professional that they have high blood pressure. High blood pressure is defined as a systolic blood pressure of 140 mmHg or greater or a diastolic blood pressure of 90 mmHg or greater.
DenominatorThe total number of survey respondents (BRFSS survey) excluding those with missing or refused values in the numerator.
Healthy People Objective HDS-5.1:Reduce the proportion of adults with hypertension
U.S. Target: 26.9 percent
State Target: 22.8 percent
How Are We Doing?The proportion of Utah adults who reported being told they had high blood pressure has remained relatively constant over the past decade. In 2015, approximately 1 in 4 (25.1%) Utah adults reported being told they had high blood pressure (age-adjusted rate). This is slightly below the U.S. Healthy People 2020 target of 26.9 percent. The Utah 2020 target is 22.8 percent. The percentage of adults who reported being told they had high blood pressure was much lower for women than men in every age group. The differences diminished by age 65 and over. In this age group, the rate of high blood pressure was 57.8 percent among men and 55.2 percent among women in 2015. Doctor-diagnosed high blood pressure varied considerably among income categories. The rate was 22.8 percent among those with annual household incomes above $75,000, and 29.9 percent among those with household incomes below $25,000 in 2015. Doctor-diagnosed high blood pressure varied by educational level. Among college graduates, the rate was 23.7 percent, lower than the rate for those with less than a high school education (32.1%) in 2015. The rate of doctor-diagnosed high blood pressure was not significantly different between Hispanic (24.2%) and non-Hispanic Utahns (25.4%) in 2015. For combined years 2014 and 2015, Black Utahns had a higher rate of doctor-diagnosed high blood pressure (33.7%) compared to the general Utah population (24.3%). The difference was statistically significant.
How Do We Compare With the U.S.?In 2015, Utah had lower age-adjusted high blood pressure prevalence (25.1%) than the U.S. (30.0%).
What Is Being Done?The Healthy Living through Environment, Policy, and Improved Clinical Care Program (EPICC) was formed in 2013, consolidating three Utah Department of Health programs (Diabetes Prevention and Control Program, Heart Disease and Stroke Prevention Program, and the Physical Activity, Nutrition and Obesity Program). The purpose of the consolidation was to ensure a productive, collaborative, and efficient program focused on health outcomes. EPICC aims to reduce the incidence of diabetes, heart disease, and stroke by targeting risk factors including reducing obesity, increasing physical activity and nutritious food consumption, and improving diabetes and hypertension control. EPICC is part of the Utah Million Hearts Coalition, which is part of a national effort to reduce the number of heart attacks and strokes in the U.S. by 1 million by 2017. The Utah Million Hearts Coalition has initiated efforts to educate primary care staff on the proper measurement of high blood pressure. Measuring high blood pressure properly helps to reduce the number of people who have high blood pressure but have not been diagnosed with the condition. It also helps to ensure that people who have been diagnosed with high blood pressure are treated effectively.
Evidence-based PracticesHealth care organizations can improve high blood pressure control among their patient populations. Some strategies that have proven effective and sustainable include: * Maximizing use of electronic medical records that allow providers to track patient care over time, and incorporate prompts and reminders to improve care. * Integrating team based care that makes full use of the skills of the team members to identify and treat patients with high blood pressure, provide patient support and follow-up care, and help patients manage their medicines and stick to a blood pressure control plan. * Reinforcing the importance of behaviors that affect blood pressure, such as eating a healthy, low sodium diet; being physically active; maintaining a healthy weight; and not smoking.
Available ServicesThe Utah Department of Health's Healthy Living through Environment, Policy, and Improved Clinical Care (EPICC) Program works with health care organizations and other partners to improve the accuracy of blood pressure measurement and to improve medication adherence for people with high blood pressure. See EPICC website for more details: [http://choosehealth.utah.gov/healthcare/practice-recommendations/hypertension.php][[br]] [[br]]
Health Program InformationIn 2012, the Utah Department of Health published a statistical report titled ''The Impact of Heart Disease and Stroke in Utah''. This report describes overall patterns in cardiovascular disease and risk factors at the state and national levels and among Utah sub-populations (age group, sex, race, ethnicity, and Utah Small Area). To download the full report, please visit [http://www.choosehealth.utah.gov/documents/pdfs/reports/HD_Stroke_Burden_Report2012.pdf].[[br]]
Page Content Updated On 10/27/2017, Published on 11/29/2017