PHOM Indicator Profile Report of Blood Pressure: Doctor-diagnosed Hypertension

Why Is This Important?

High blood pressure (hypertension) is an important risk factor for heart disease and stroke. In most cases, it can be effectively managed with medication and lifestyle changes (such as diet, exercise, and abstaining from tobacco use). Treatment works best when high blood pressure is identified early. Because high blood pressure does not produce symptoms, regular screening is recommended. In most cases, high blood pressure is defined as a systolic (upper) number of 140 or greater and a diastolic (lower) number of 90 or greater.

The rate of hypertension among Utah adults was significantly lower than the rate for U.S. adults (27.6% vs. 30.3%) in 2021. Data are only collected in odd years.

Data 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].

Risk Factors

Some risk factors for high blood pressure cannot be changed, such as family history and genetics, but some can be reduced through lifestyle changes. These include engaging in regular physical activity, reducing excess weight, tobacco cessation or abstinence, and low-sodium diet. Social and environmental factors such as access to preventive health services, income, and discrimination are also related to the risk of high blood pressure. Certain medications, including over-the-counter medications, can affect blood pressure as well. Individuals are encouraged to discuss their risk factors with a physician and monitor their blood pressure regularly.

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).

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.

Healthy People Objective: Reduce the proportion of adults with hypertension

U.S. Target: 26.9 percent
State Target: 22.8 percent