Agency for Healthcare 

Medical Expenditure Panel Survey Research and Quality 

STATISTICAL BRIEF #59 

December 2004 

Hypertension in America, 2002: 

Estimates for the U.S. Civilian Noninstitutionalized Population Ages 18 

and Older 

William Carroll, BS 

Introduction 

Hypertension, commonly referred to as high blood pressure, is a 

serious medical condition which, if not controlled, can lead to more 

serious cardiovascular conditions. Data from the Household 

Component of the 2002 Medical Expenditure Panel Survey (MEPSHC) show that an estimated 21.3 percent or 45.3 million adults 18 

years old and older had been told by a health care professional at 

two or more different medical visits that they had hypertension. This 

estimate is based on reports for all household members by a single 

household respondent during the MEPS household interview, and it 

only includes diagnosed hypertension. An estimated 31 percent of 

adults with hypertension are unaware they have the condition.* 

Diagnosed hypertension as reported by household respondents in 

the MEPS is not distributed evenly across all subgroups of adults. 

Specifically, the percentage of adults with diagnosed hypertension 

differs by gender, race/ethnicity, age, educational attainment, family 

income, and insurance status. 

Lifestyle factors, such as exercise, weight control, and stress 

reduction, can affect the risk and impact of hypertension. MEPS data 

show that regular exercise, maintaining a healthy weight, and having 

a low level of stress are all positively correlated with lower rates of 

diagnosed hypertension. 

All differences between estimates discussed in the text are 

statistically significant at the 0.05 level. 

* Burt, Vicki L., Paul Whelton, Edward J. Roccella, et al. "Prevalence of Hypertension 

in the U.S. Adult Population. Results from the Third National Health and Nutrition 

Examination Survey, 1988–1991." Hypertension vol. 25, no. 3, March 1995, pp. 305– 

313. 

Highlights 

� 21.3 percent or 45.3 million 

adults reported having been 

told at two or more different 

health care visits that they 

have hypertension. 

� The percentage of nonHispanic blacks ever diagnosed with hypertension was 

higher than for non-Hispanic 

whites (28.5 percent and 

22.1 percent, respectively), 

while the percentage among 

Hispanics was lower than for 

non-Hispanic whites (12.3 

percent and 22.1 percent, 

respectively). 

� The percentage of adults 

ever diagnosed with 

hypertension was 1.4 times 

greater for those with less 

than a high school education 

than for those with a college 

education (25.3 percent and 

17.6 percent, respectively).

� The percentage of overweight, obese, and morbidly 

obese (combined) adults 

ever diagnosed with hypertension was twice that of 

healthy weight adults (26.7 

percent and 13.2 percent, 

respectively). 

� Among adults 18 to 64 years 

old, uninsured adults were 

substantially less likely to 

have ever been diagnosed 

with hypertension than adults 

covered only by public health 

insurance (9.3 percent and 

22.9 percent, respectively), 

or covered by any private 

health insurance (9.3 percent 

and 15.1 percent, 

respectively). 
Findings 

Demographic and Socioeconomic Characteristics 

In 2002, slightly more adult women than men had ever been diagnosed with hypertension (22.3 percent 

and 20.2 percent, respectively) (figure 1). The difference between men and women, however, was greater 

in older age groups. For example, among adults 65 years and older, 57.3 percent of women had a 

hypertension diagnosis compared to 51.8 percent of men (data not shown in figure). 

The percentage of adults ever diagnosed with hypertension also varied across various race/ethnic groups 

and by age (figure 1). The percentage was higher among non-Hispanic black adults (28.5 percent) 

compared to non-Hispanic white adults (22.1 percent), while the rate among Hispanics (12.3 percent) was 

lower than that of non-Hispanic whites and non-Hispanic blacks. A positive relationship existed between 

diagnosed hypertension and age (1.3 percent among persons 18 to 24 years old and 55.0 percent among 

persons 65 years and older). 

The percentage of adults ever diagnosed with hypertension also differed according to selected 

socioeconomic characteristics (figure 2). The percentage among adults with less than a high school 

education was 1.4 times greater than for adults with a college education (25.3 percent and 17.6 percent, 

respectively). Differences also existed by income (24.9 percent among low income adults versus 20.0 

percent among high income adults). 

Health Insurance Status 

Among adults 18 to 64 years old, the likelihood of ever being diagnosed with hypertension was lowest 

among uninsured adults (9.3 percent) and highest among those covered only by public insurance (22.9 

percent). Rates for adults with any private health insurance were in between (15.1 percent) (figure 3). 

Figure 3 shows that as age increases, the difference in the rate of ever being diagnosed with 

hypertension, between insured and uninsured adults, widens. 

Lifestyle Factors 

Healthy lifestyles can help reduce the risk and impact of hypertension. Figure 4 shows that the 

percentage of adults ever diagnosed with reported hypertension increased progressively with increasing 

body weight (as reported by the household respondent). The percentage of overweight, obese, and 

morbidly obese (combined) adults ever diagnosed with hypertension was twice that of normal weight 

adults (26.7 percent and 13.2 percent, respectively). Specifically, the percentage of overweight adults 

with diagnosed hypertension was 21.3 percent compared to 13.2 percent among normal weight adults. 

More striking, however, was the 3.3 times higher percentage of morbidly obese adults ever diagnosed 

with hypertension compared to normal weight adults (44.1 percent and 13.2 percent, respectively). About 

58 percent of the adults with diagnosed hypertension were advised by a health professional to eat fewer 

high-fat or high-cholesterol foods (data not shown in figure). 

The percentage of adults ever diagnosed with hypertension also varied by exercise activity and stress 

level. The percentage among adults who reported that they spent half an hour or more in moderate or 

vigorous physical activity at least three times a week was lower than among persons not reporting this 

level of exercise activity (17.5 percent and 26.3 percent, respectively). About 61 percent of the adults with 

hypertension were advised by a health professional to exercise more (data not shown in figure). 

Regarding stress, 20.3 percent of adults who reported that they felt calm at least "a good bit of the time" 

had been diagnosed with hypertension compared to 25.6 percent of adults that at best reported feeling 

calm "some of the time." 

Considering the above lifestyle factors together, 18.4 percent of all adults reported that they exercised 

regularly, had a normal weight, and felt calm at least "a good bit of the time"; the percentage that had 

been diagnosed with hypertension among this group was 11.6 percent, compared to 24.0 percent for the 

rest of the adult population (data not shown in figure). 

The 2002 MEPS-HC data also show that 17.0 percent of adults who had ever been diagnosed with 

hypertension were current smokers and that about 66 percent of those had been advised by a doctor to 

quit smoking within the past 12 months (data not shown in figure). 
Data Source 

This Statistical Brief summarizes data concerning the prevalence of diagnosed hypertension in the United 

States during 2002 as reported in the 2002 MEPS-HC by the designated household respondent during 

the household interview (see HC-062: 2002 Full Year Population Characteristics public use file). The 

conditions data are from the Priority Conditions Section, which were administered in Round 3/5. Item 

nonresponse rates for the items reported in this brief ranged from 0 percent to 5.2 percent. No 

adjustments were made for item nonresponse. 

Definitions/Methodology 

Hypertension 

The following question was used to identify persons with hypertension: “Were you told on two or more 

different visits that you had hypertension, also called high blood pressure?" The household respondent 

was asked this question about himself or herself and the other adults living in the household. 

Body Mass Index (BMI) 

– Underweight: BMI is less than 18.5 

– Normal weight: BMI is between 18.5 and 24.9 inclusive 

– Overweight: BMI is between 25.0 and 29.9 inclusive 

– Obesity: BMI is between 30.0 and 39.9 inclusive 

– Morbidly obese: BMI greater than or equal to 40.0 

Stress 

The following question from the Self-Administered Questionnaire was used as a measure for stress: "How 

much of the time during the past four weeks have you felt calm and peaceful? All of the time, most of the 

time, a good bit of the time, some of the time, a little of the time, or none of the time?" The assumption is 

that people reporting feeling calm and peaceful only some of the time, a little of the time, or none of the 

time are potentially experiencing unhealthy amounts of stress. 

Education level 

Respondents were asked to report the highest grade or year of schooling ever completed by each family 

member as of the date of the interview: not a high school graduate (grade less than 12), high school 

graduate/GED/other (grade 12 or equivalent or some college), and college graduate. 

Poverty status 

Each person in the survey sample was classified according to the total yearly income of his or her family. 

Within a household, all individuals related by blood, marriage, or adoption were considered to be a family. 

Personal income from all family members was summed to create family income. 

Poverty status is the ratio of family income to the Federal poverty thresholds, which control for family size 

and age of the head of family. Categories are defined as follows: 

– Poor/near poor: This refers to persons in families with incomes under 125 percent of the poverty 

line and also includes persons with negative income. 

– Low income: This category includes persons in families with income over 125 percent through 

200 percent of the poverty line. 

– Middle income: This category includes persons in families with income over 200 percent through 

400 percent of the poverty line. 

– High income: This category includes persons in families with income over 400 percent of the 

poverty line. 

Health insurance status 

Health insurance status was constructed hierarchically in the following order: 

– Any private coverage: Private health insurance coverage was defined as nonpublic insurance that 

provided coverage for hospital and physician care (including Medigap coverage). TRICARE was 

considered private coverage 

– Public only coverage: Adults were considered to have public only health insurance coverage if they 

were not covered by private insurance, and they were covered by Medicare, Medicaid, or other public 

hospital and physician coverage. 

– Uninsured: Adults classified as uninsured did not have public or private health insurance coverage. 

People covered only by noncomprehensive state-specific programs (e.g., Maryland Kidney Disease 
Program) or private single-service plans (e.g., coverage for dental or vision care only, coverage for 

accidents or specific diseases) were not considered to be insured. 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is 

cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health 

Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1406) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References 

For a detailed description of the MEPS-HC survey design, sample design, and methods used to minimize 

sources on nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Suggested Citation 

Carroll, W. Hypertension in America, 2002: Estimates for the U.S. Civilian Noninstitutionalized Population 

Ages 18 and Older. Statistical Brief #59. December 2004. Agency for Healthcare Research and Quality, 

Rockville, MD. http://www.meps.ahrq.gov/papers/st59/stat59.pdf 
Expenditure Panel Survey, 2002 

demographic characteristics: Adults 18 and older, 2002 

17.1 

1.3 

7.7 

29.0 

55.0 

20.2 22.3 22.1 

12.3 

28.5 

0 

15 

30 

45 

60 

Male Non-Hispanic 

white, single 

race 

Non-Hispanic 

black, single 

race 

Hispanic, any 

race 

Non-Hispanic 

other/multiple 

races 

18-24 25-44 45-64 65+ 

Percent 

Sex Race Age 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical 

Figure 1. Percentage with reported hypertension, by 

Female 

Expenditure Panel Survey, 2002 

socioeconomic characteristics: Adults 18 and older, 2002 

20.3 20.0 

25.3 

21.5 

17.6 

24.0 24.9

0 

10 

20 

30 

Less than HS HS/GED/Other College graduate Poor/Near poor Middle income High Income 

Percent 

Education Income 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical 

Figure 2. Percentage with reported hypertension, by 

Low income 
Expenditure Panel Survey, 2002 

insurance status and age: Adults 18 to 64, 2002 

1.0 

30.0 

1.0 

5.0 

15.1 

22.9 

9.3 8.0 

24.0 

0 

10 

20 

30 

Any private Public only 18-24 25-44 45-64 

Insured Uninsured 

Percent 

Health insurance status Insured vs. uninsured by age 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical 

Figure 3. Percentage with reported hypertension, by health 

Uninsured

Expenditure Panel Survey, 2002 

lifestyle factors: Adults 18 and older, 2002 

26.3 

20.3 

25.6 

17.5 

33.1 

44.1 

21.3 

12.7 13.2

0 

10 

20 

30 

40 

50 

Underweight Normal 

weight 

Morbidly Yes No No 

Percent 

Exercise three 

times a week 

Feel calm at least “a 

good bit of the time” 

Weight 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical 

Figure 4. Percentage with reported hypertension, by selected 

Overweight Obese 

obese 

Yes