Validity of self-reported hypertension in the National Health and Nutrition Examination Survey III, 1988-1991.
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 > or = 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.
Vargas
C M
CM
National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland 20782, USA.
Burt
V L
VL
Gillum
R F
RF
Pamuk
E R
ER
D000328:Adult; D044383:Black People; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000208:ethnology*; D008019:Life Style; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D009749:Nutrition Surveys; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D011795:Surveys and Questionnaires / Q000592:standards*; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American