Health Indicator Report of Blood Pressure: Doctor-diagnosed Hypertension

Notes

Doctor-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", "Yes but females 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 to increase the precision of the estimate. Data in IBIS charts have been updated back to 2011 forward to reflect this change. With this change, age adjustment for Utah is more consistent with both the U.S. and other states using IBIS.   [[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.utah.gov/ibisph-view/pdf/opha/resource/brfss/RakingImpact2011.pdf].

Data Interpretation Issues

Data are self-reported and subject to respondents' recall and accuracy of reporting. To reduce sampling bias and more accurately represent population data, the BRFSS has changed survey methodology. In 2011, 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: [[a href="pdf/opha/resource/brfss/RakingImpact2011.pdf" Raking Fact Sheet 2011]].

Definition

The percentage of adults who have ever been told by a doctor, nurse, or other health professionals that they have high blood pressure. This indicator is used to estimate the prevalence of high blood pressure in Utah. Data are from the Utah Behavioral Risk Factor Surveillance System (BRFSS).

Numerator

The number of survey respondents who report they have ever been told by a doctor, nurse, or other health professionals that they have high blood pressure.

Denominator

The total number of survey respondents (BRFSS survey) excluding those with missing or refused values in the numerator.

Healthy People Objective: 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 stable over the past decade. In 2021, more than one in four (27.6%) Utah adults reported being told they had high blood pressure (age-adjusted rate). The percentage of adults who reported being told they had high blood pressure was much lower for females than males in every age group. The gender differences were less pronounced by age 65 and over. In this age group, the rate of high blood pressure was 54.9% among men and 52.0% for women in 2021 (crude rates). Rates of doctor-diagnosed high blood pressure are somewhat similar among income categories. The rate was 25.5% among those with annual household income above $75,000, and 30.2% among those with household income below $25,000 in 2021 (age-adjusted rate). Doctor-diagnosed high blood pressure varied by educational level. Among college graduates, the rate was 26.0%, lower than the rate for those with less than a high school education (34.2%) in 2021. These rates represent adults aged 25 and over (age-adjusted rates). The rate of doctor-diagnosed high blood pressure was not significantly different between Hispanic (29.0%) and non-Hispanic Utahns (27.6%) in 2021 (age-adjusted rates).

How Do We Compare With the U.S.?

In 2021, Utah had a lower age-adjusted high blood pressure prevalence (27.6%) than the U.S. (30.3%).

What Is Being Done?

The Healthy Environments Active Living (HEAL) Program was previously known as the Healthy Living through Environment, Policy, and Improved Clinical Care (EPICC) Program. EPICC was created in 2013, consolidating three Utah Department of Health and Human Services (DHHS) programs (the 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. HEAL 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. HEAL is part of the Utah Million Hearts Coalition. [https://millionhearts.hhs.gov/index.html Million Hearts 2027] is an initiative co-led by the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services. Million Hearts aimed to reduce the number of heart attacks and strokes in the U.S. by 1 million by 2027. The Utah Million Hearts Coalition has initiated efforts to educate staff in primary care clinics on the proper techniques for measuring high blood pressure.

Evidence-based Practices

Health care organizations can improve high blood pressure control among their patient populations. Some strategies that have proven effective and sustainable include: *Maximizing the 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 health care 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 maintaining behaviors that affect blood pressure, such as eating a healthy, low sodium diet; being physically active; maintaining a healthy weight; and abstaining from smoking.

Available Services

The Utah Department of Health and Human Services Healthy Environments Active Living (HEAL) 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 the HEAL website for more details: [https://heal.utah.gov/heart%20health/].

Health Program Information

In 2012, DHHS 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 click [https://heal.health.utah.gov/wp-content/uploads/2021/11/Heart-Disease-and-Stroke-Burden-Report-2012.pdf here]. The Utah Department of Health and Human Services, Healthy Environments Active Living program plays a key role in improving the health of residents in the state of Utah. The program was formed in July 2013 (as EPICC), through a new funding opportunity from the Centers of Disease Control and Prevention (CDC) that allowed for the merging of three previously existing programs: the Heart Disease and Stroke Prevention Program, the Diabetes Prevention and Control Program, and the Physical Activity, Nutrition and Obesity Program, as well as the addition of a school health program. The Healthy Environments Active Living Program (HEAL) was recently restructured as part of this strategic planning process and the new program model focuses on working together with staff and partners to address the social determinants of health while advancing health equity and increasing policy, systems and environment changes. HEAL champions public health initiatives and addresses the challenges of making health awareness and access truly universal and equitable in eight key areas: nutrition, heart health, diabetes, physical activity, schools, child care, community health workers, and worksites. Visit [https://heal.health.utah.gov/ HEAL?s website] for more information.