Validity of Self-Reported Hypertension in the National Health and Nutrition Examination Survey III, 1988–1991

• Published in: Preventive medicine 1997-09, Vol.26 (5), p.678-685
• Main Authors: Vargas, Clemencia M., Burt, Vicki L., Gillum, Richard F., Pamuk, Elsie R.
• Format: Article
• Language: English
• Subjects: Adult; Black or African American; Black People; blood pressure; Female; Health Services Accessibility; Humans; Hypertension; Hypertension - diagnosis; Hypertension - ethnology; Life Style; Male; Mexican Americans; Middle Aged; NHANES; Nutrition Surveys; Population Surveillance - methods; Prevalence; Reproducibility of Results; Sensitivity and Specificity; Sex Distribution; Surveys and Questionnaires - standards; United States - epidemiology; validity, sensitivity, and specificity; White People
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1006/pmed.1997.0190

Background.The National Health and Nutrition Examination Survey (NHANES) is the main data source for hypertension surveillance. However, because of a gap of almost 10 years between each NHANES, self-reported data from annual surveys need to be examined as an alternative data source. This study analyzes the validity of self-reported hypertension in a national sample of non-Hispanic whites, non-Hispanic blacks, and Mexican-Americans. Methods.Sensitivity, specificity, and predictive values positive (PVP) and negative (PVN) of self-reported hypertension were calculated against two definitions of hypertension: the definition recommended by the Third Joint National Committee on Hypertension, JNC III (blood pressure ≥140/90 and/or taking antihypertension medication) and a broader definition including control with lifestyle modifications. Data used come from the NHANES III, 1988–1991. Results.Overall test characteristics using the JNC III definition are sensitivity 71%, specificity 90%, PVP 72%, and PVN 89%. Test characteristics were consistently higher for the broad than for the JNC III definition. Validity of self-reported hypertension is higher among women than among men and among persons with a medical visit during the past year than among those with no visits: validity was lowest among Mexican-American men. Due to the similarity between sensitivity and PVP, the prevalence of self-reported hypertension is nearly equal to the prevalence of JNC III-defined hypertension. Conclusions.Self-reported hypertension may be used for surveillance of hypertension trends, in the absence of measured blood pressure, among non-Hispanic whites and non-Hispanic black women and persons with a medical visit in the past year. Validation should be repeated with each NHANES.