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 health systems can use to compare their reported hypertension prevalence with their expected prevalence. Tool users provide the number of patients aged 18–85 years treated annually, stratified by gender, 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 versus 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.

Application of a Tool to Identify Undiagnosed Hypertension — United States, 2016

“…Approximately 11 million U.S. adults with a usual source of health care have undiagnosed hypertension, placing them at increased risk for cardiovascular events ( 1 – 3 ). Using data from the National Health and Nutrition Examination Survey (NHANES), CDC developed the Million Hearts Hypertension Prevalence Estimator Tool, which allows health care delivery organizations (organizations) to predict their patient population’s hypertension prevalence based on demographic and comorbidity characteristics ( 2 ). Organizations can use this tool to compare predicted prevalence with their observed prevalence to identify potential underdiagnosed hypertension.…”

“…Predicted hypertension prevalence was determined by applying the Hypertension Prevalence Estimator Tool to the organizations’ data; development and validation of the tool are described elsewhere ( 2 ). The tool requires input of the patient population’s demographic characteristics (i.e., distribution by sex, race/ethnicity, and age group) with the option §§ of providing the prevalence of three comorbidities within the patient population that aid in predicting hypertension prevalence (i.e., the presence of none, one, or two or more of the following conditions: obesity, diabetes, and chronic kidney disease).…”

TyG-BMI and hypertension in Normoglycemia subjects in Japan: A cross-sectional study

“…38,39 Currently, there are relatively few predictive tools for HTN, leading to people not knowing their risk of developing HTN, and thus not being able to manage it well. 40 Although the current gold standard for IR testing is the hyperinsulinemic-euglycemic clamp technique, this method is difficult to apply in large epidemiological studies; therefore, the use of indirect IR scores can be applied in large epidemiological studies. However, for less-developed areas, IR scores based on insulin assays, such as HOMA-IR, are difficult to obtain.…”

Influence of altitude on hypertension phenotypes and responses to antihypertensive therapy: Review of the literature and design of the INTERVENCION trial

“…Hypertension is considered a major global public health issue, and the high burden of hypertension in developing countries is increasingly being recognized 6 . The World Hypertension League has made important efforts to address the current extent of hypertension worldwide by raising awareness of the effects of hypertension in low‐ and middle‐income countries where the majority of high‐altitude (HA) locations are, addressing the effects of dietary salt consumption on BP, and developing hypertension prevalence estimator tools, which constitute relevant approaches to lower hypertension morbidity and mortality 7‐10 . Approximately 83 million people live at HA, classically defined as >2500 meters above sea level (mASL; ~8200 ft) 11 .…”