Blood Pressure Measurements From Self-Service Health Kiosks in US Retail Stores, 2017-2024

Abstract

Importance: Hypertension is the leading risk factor for mortality in the US. Current national estimates of the prevalence of high blood pressure (BP) are derived from lagged averages based on complex, multistage, probability sampling designs to be representative of the US population.

Objective: To describe the distribution of BP readings among a convenience sample of individuals aged 18 to 99 years.

Design, setting, and participants: This was a serial cross-sectional analysis conducted from November 2017 to September 2024. The setting included Pursuant Health kiosk data at retail locations from 1892 counties in 49 US states (except Massachusetts) and the District of Columbia. Included were adult users of health kiosks.

Exposures: Two-year periods (2017-2018 to 2023-2024), age, gender, race, and ethnicity.

Main outcomes and measures: Users of health kiosks were self-selected visitors at retail locations. High BP was defined as either self-report of a diagnosis of hypertension or elevated BP measurement (systolic ≥140 mm Hg or diastolic ≥90 mm Hg). Among respondents with and without self-reported hypertension, proportions of individuals were estimated according to their systolic and diastolic BP (<120 and <80 mm Hg; 120-129 and <80 mm Hg; 130-139 or 80-89; and ≥140 mm Hg or ≥90 mm Hg).

Results: The analytic sample of 1 270 485 individuals had a mean (SD) age of 42.0 (15.6) years, 661 947 (52.1%) were men, and 219 086 (17.2%) were rural residents. Participants self-reported the following races and ethnicities: 87 553 non-Hispanic Asian (6.9%), 232 050 non-Hispanic Black (18.3%), 336 503 Hispanic (26.5%), 532 561 non-Hispanic White (41.9%), and 81 818 other race or ethnicity (6.4%). The prevalence of high BP was 50.0% (95% CI, 49.7%-50.2%) in 2017 to 2018 and 47.6% (95% CI, 47.4%-47.8%) in 2023 to 2024. Prevalence was highest among non-Hispanic Black populations across all time periods. In 2023 to 2024, prevalence was 55.6% (95% CI, 55.1%-56.0%) among non-Hispanic Black and 50.4% (95% CI, 50.1%-50.7%) and 41.0% (95% CI, 40.7%-41.4%) among non-Hispanic White and Hispanic adults, respectively. Higher prevalence was observed among those older than 65 years (eg, 2017-2018: 71.9%; 95% CI, 71.3%-72.6%) and adults in rural settings (eg, 2017-2018: 51.2%; 95% CI, 50.6%-51.8%) across all periods. Self-report of a hypertension diagnosis was 34.7% (95% CI, 34.4%-34.9%) in 2017 to 2018 and 35.9% (95% CI, 35.7%-36.1%) in 2023 to 2024. Among those who reported a hypertension diagnosis, the proportions of individuals with systolic BP greater than or equal to 140 mm Hg or diastolic BP greater than or equal to 90 mm Hg were 32.1% (95% CI, 31.7%-32.5%) in 2017 to 2018 and 28.1% (95% CI, 27.8%-28.3%) in 2023 to 2024.

Conclusions and relevance: In this cross-sectional analysis of a convenience sample of US adults who measured their BP at self-service kiosks at national retail stores, results reveal that frequency of self-report of hypertension and elevated BP measurements was high. Usage of health kiosks is more common among populations traditionally underrepresented in national surveys.