Development and Validation of a Hypertension Prevalence Estimator Tool For Use in Clinical Settings

Abstract

Health systems are well positioned to identify and control hypertension among their patients. However, almost one third of US adults with uncontrolled hypertension are currently receiving medical care and are unaware of being hypertensive. This study describes the development and validation of a tool that health systems can use to compare their reported hypertension prevalence with their expected prevalence. Tool users provide the number of patients aged 18 to 85 years treated annually, stratified by sex, age group, race/ethnicity, and comorbidity status. Each stratum is multiplied by stratum-specific national prevalence estimates and the amounts are summed to calculate the number of expected hypertensive patients. The tool's validity was assessed by applying samples from cohorts with known hypertension prevalence; small differences in expected vs actual prevalence were identified (range, -3.3% to 0.6%). This tool provides clinically useful hypertension prevalence estimates that health systems can use to help inform hypertension management quality improvement efforts.

Figure 1

National hypertension prevalence estimates and awareness status among adults with a primary healthcare visit within the past year, by sex, age, and comorbidity status (National Health and Nutrition Examination Survey [NHANES], 1999–2012). ^aRepresented as the number of comorbidities, including obesity, diagnosed diabetes, and chronic kidney disease.