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U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion

Increase control of high blood pressure in adults — HDS‑05 Data Methodology and Measurement

This objective is a Leading Health Indicator (LHI). Learn about LHIs.

On this page:  About the National Data  |  Methodology  |  History

About the National Data

Data

Data Source:  National Health and Nutrition Examination Survey (NHANES), CDC/NCHS

Baseline: 16.1 percent of adults aged 18 years and over with high blood pressure/hypertension had it under control in 2017-20

Target: 18.9 percent

Numerator
Number of adults aged 18 years and over, excluding pregnant women, with hypertension whose mean systolic blood pressure is less than 130 mm Hg and mean diastolic blood pressure is less than 80 mm Hg.
Denominator
Number of adults with high blood pressure/hypertension aged 18 years and over, excluding pregnant women.
Target-setting method
Minimal statistical significance
Target-setting method details
Minimal statistical significance, assuming the same standard error for the target as for the baseline.
1
Target-setting method justification
The standard error was used to calculate a target based on minimal statistical significance, assuming the same standard error for the target as for the baseline. This method was used because hypertension control has had little change over the past several National Health and Nutrition Examination Survey (NHANES) cycles, and the Healthy People 2030 Workgroup Subject Matter Experts expected minimal improvement in the next decade.

Methodology

Questions used to obtain the national baseline data

(For additional information, please visit the data source page linked above.)

From the 2017-2020 National Health and Nutrition Examination Survey:

Numerator and Denominator:
{Have you/Has SP} ever been told by a doctor or other health professional that {you/s/he} had hypertension, also called high blood pressure?
  1. Yes
  2. No
  3. Refused
  4. Don't know
Because of {your/SP's} high blood pressure/hypertension, {have you/has s/he} ever been told by a doctor or other health professional to take prescribed medication?
  1. Yes
  2. No
  3. Refused
  4. Don't know
{Are you/Is SP} now taking prescribed medication?
  1. Yes
  2. No
  3. Refused
  4. Don't know

Methodology notes

Adults are defined as having high blood pressure/hypertension if they either: (a) have a measurement of mean systolic blood pressure (SBP) ≥130 mm Hg or (b) mean diastolic blood pressure (DBP) ≥80 mm Hg or (c) report that they are taking high blood pressure medicine.

Blood pressure is measured by averaging up to 3 blood pressure readings taken during the physical examination in the NHANES mobile examination center.

Blood pressure has been measured with the mercury sphygmomanometer for many years but with new technologies available, alternative blood pressure devices have taken center stage. The rapid pace of the development of automated sphygmomanometers with improving accuracy and reliability combined with increasing affordability has meant that these devices have now replaced the mercury sphygmomanometer in many settings. A detailed description of the procedures for blood pressure measurement in the NHANES has been published elsewhere.

https://wwwn.cdc.gov/Nchs/Data/Nhanes/2015-2016/Manuals/2015_Physician_Examination_Procedures_Manual.pdf
https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/BPX_I.htm

Age-adjustment notes

This Indicator uses Age-Adjustment Groups:

  • Total: 18-49, 50-59, 60-69, 70-79, 80+
  • Sex: 18-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 18-49, 50-59, 60-69, 70-79, 80+
  • Educational Attainment: 25-49, 50-59, 60-69, 70-79, 80+
  • Family Income (percent poverty guidelines): 18-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 18-49, 50-59, 60-64
  • Marital Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 18-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Activity Limitations: 20-49, 50-59, 60-69, 70-79, 80+
  • Obesity Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Diabetes Status: 18-49, 50-59, 60-69, 70-79, 80+

History

Comparable HP2020 objective
Modified, which includes core objectives that are continuing from HP2020 but underwent a change in measurement.
Changes between HP2020 and HP2030
This objective differs from Healthy People 2020 objective HDS-12, which defined hypertension based on the Joint National Committee 7 guidelines as a systolic blood pressure of 140 mm Hg or higher or a diastolic blood pressure of 90 mm Hg or higher. This objectives uses the 2017 American College of Cardiology and American Heart Association guidelines to define hypertension as a systolic blood pressure of 130 mm Hg or higher or a diastolic blood pressure of 80 mm Hg or higher.
Revision History
Revised. 

In 2022, the baseline was revised from 47.8% in 2013-2016 to 16.1% in 2017-2020 for consistency with the new 2017 guidelines on high blood pressure in adults released by the American College of Cardiology and American Heart Association released. As part of the new guidelines, the categorization of high blood pressure was changed from the previous definition recommended in the Joint National Committee 7 report. The categorization of high blood pressure was modified from a systolic blood pressure of ≥140 mm Hg to ≥130 mm Hg or a diastolic blood pressure of ≥90 mm Hg to ≥80 mm Hg. The target was revised from 60.8% to 18.9% using Minimal Statistical Significance instead of the original target setting method of Projection.

1. Target setting method has been revised. See Data Methodology and Measurement for more information.