title: Predictors of congruency between self-reported hypertension status and measured blood pressure in the stroke belt.
abstract: BACKGROUND
  Few studies have comprehensively investigated the validity of self-reported hypertension (HTN) and assessed predictors of HTN status in the stroke belt. This study evaluates validity self-reporting as a tool to screen large study populations and determine predictors of congruency between self-reported HTN and clinical measures.
  
  
  METHODS
  Community Initiative to Eliminate Stroke project (n = 16,598) was conducted in two counties of North Carolina in 2004 to 2007, which included collection of self-reported data and clinical data of stroke-related risk factors. Congruency between self-reported HTN status and clinical measures was based on epidemiological parameters of sensitivity, specificity, and predictive values. McNemar's test and Kappa agreement levels assessed differences in congruency, while odds ratios and logistic regression determined significant predictors of congruency.
  
  
  RESULTS
  Sensitivity of self-reported HTN was low (33.3%), but specificity was high (89.5%). Prevalence of self-reported HTN was 16.15%. Kappa agreement between self-report and clinical measures for blood pressure was fair (k = 0.25). Females, whites, and young adults were most likely to be positively congruent, whereas individuals in high risk categories for total blood cholesterol, low density lipoproteins, triglycerides, and diabetes were least likely to accurately capture their HTN status.
  
  
  CONCLUSIONS
  Self-report HTN information should be used with caution as an epidemiological investigation tool.
authors.affiliation: North Carolina Translational and Clinical Sciences (NC TraCS) Institute, University of North Carolina, Chapel Hill, NC, USA. Electronic address: gjdave@email.unc.edu.
authors.forename: Gaurav J
authors.initials: GJ
authors.lastname: Dave
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Bibeau
authors.forename: Mark R
authors.initials: MR
authors.lastname: Schulz
authors.forename: Robert E
authors.initials: RE
authors.lastname: Aronson
authors.forename: Louise L
authors.initials: LL
authors.lastname: Ivanov
authors.forename: Adina
authors.initials: A
authors.lastname: Black
authors.forename: LaPronda
authors.initials: L
authors.lastname: Spann
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D057566:Self Report / Q000592:standards*; D012680:Sensitivity and Specificity; D020521:Stroke / Q000453:epidemiology*; D055815:Young Adult
keywords: Hypertension; diastolic blood pressure; self-reports; sensitivity; systolic blood pressure; validation