Validity of Self-Reported Hypertension Status in a Community-Based Stroke Prevention Program

Collectively, cardiovascular diseases and stroke are the leading causes of death in the U.S. and are included among the focus areas in Healthy People 2010. Hypertension is one of the chief risk factors leading to the development of CVDs and stroke in the U.S. The Framingham Heart Study researchers found that the lifetime risk for hypertension among non-hypertensives after the age of 55 years is approximately 90 percent for both men and women in the U.S. Community Initiative to Eliminate Stroke (CITIES) of North Carolina was a three year federally funded initiative implemented in Guilford and Forsyth counties. The main components of the project were stroke risk assessment screening for resident, including self-reporting of hypertension status, clinical blood pressure measures (n = 15,717) and risk reduction services in the community organizations.

The sensitivity and specificity of the screening test were 33% and 89.5% respectively among participants who did not take any blood pressure lowering medications. 16.6% of participants self-reported as not having hypertension and were found to have elevated blood pressure levels. 48% of participants who were on blood pressure lowering medications had elevated levels of systolic and/or diastolic blood pressure. This session will provide an overview of the results obtained through analysis of screening data and evaluate the concordance of self-reported hypertension status compared to measurement of blood pressure levels. This session will allow participants to understand the implications of utilizing self-report as an expedient tool for screening large numbers of people and make recommendations for future research.