Scottish Health Survey 2013 - volume 1: main report
Presents results for the 2013 Scottish Health Survey, providing information on the health and factors relating to health of people living in Scotland.
8 Long-Term Conditions
Lisa Rutherford
SUMMARY
Long-term conditions
- Prevalence did not change significantly for adults between 2012 and 2013. Forty-four percent of adults had a long-term condition in 2013, with one in three (31%) reporting that they had a condition that limited their daily activities in some way.
- Women remain significantly more likely than men to have a long-term condition (46% compared with 41%).
- Around one in six (17%) children aged 0-15 had a long-term condition in 2013 (19% of boys and 15% of girls) and for 9% their condition limited their daily activities in some way.
- The proportion of boys reporting that they had a long-term condition increased significantly between 2008 and 2013 (from 15% to 19%) but did not change between 2012 and 2013.
Asthma
- Asthma prevalence did not change significantly in 2013. Sixteen percent of adults and 13% of children reported that they had been diagnosed with asthma by a doctor.
- Levels of doctor-diagnosed asthma did not vary significantly between boys and girls in 2013 (15% and 12%, respectively).
Chronic Obstructive Pulmonary Disease (COPD)
- In 2013, 4% of adults reported that they had been diagnosed with Chronic Obstructive Pulmonary Disease (COPD) by a doctor. COPD prevalence has not changed significantly since 2008.
Cardiovascular disease (CVD)
- One in six (15.5%) adults, in 2013, reported that they had been diagnosed with a cardio-vascular disease (CVD) condition by a doctor, while 18.9% reported being diagnosed with any CVD condition including diabetes.
- Doctor-diagnosed diabetes prevalence was 5.6% for adults (6.1% for men and 5.1% for women) in 2013.
- One in twelve (8.3%) adults, in 2013, reported that a doctor had diagnosed them with Ischaemic Heart Disease (IHD) or stroke (9.5% of men and 7.2% of women).
Hypertension
- Hypertension levels in 2012/2013 were not significantly different from those recorded in 1998. One in three (29.1%) adults aged 16 and over had survey-defined hypertension in the years 2012/2013 combined.
- Increasing age was a risk factor for hypertension, with prevalence ranging from 10.4% and 1.6% for men and women aged 16-24 to 54.4% for men aged 64-74 and 71.8% for women aged 75 and over.
- With the exception of those aged 65 and over, more than half of cases of survey-defined hypertension in men were untreated.
- Hypertension treatment rates increased with age for both men and women.
- Where hypertension was treated, in more than half of cases it was not controlled.
- In 2012/2013, 22.8% adults had doctor-diagnosed hypertension, compared with 29.1% that had survey-defined hypertension. The difference been doctor-diagnosed and survey-defined hypertension was slightly largely for men than for women (7.4 percentage points, compared with 5.3 for women).
- The level of survey defined hypertension remained stable between 2003 and 2010/2011 for adults aged 16 and over (32.5-32.9%), before dropping significantly to 28.4% in 2012/2013 (2012/2013 figure is based on adjusted estimates).
8.1 INTRODUCTION
In the Scottish Government's National Action Plan on long-term conditions[1], long-term conditions are defined as 'health conditions that last a year or longer, impact on a person's life, and may require ongoing care and support'. Conditions include mental health problems and a wide range of physical conditions such as chronic pain, arthritis, inflammatory bowel disease.
Long-term conditions account for 80% of all GP consultations and for 60% of all deaths in Scotland.[1] People with a condition are twice as likely as those without to be admitted to hospital and stay in hospital disproportionately longer.[2] It is estimated that by 2031, there will be a 60% increase in the number of people aged 75 and over in Scotland.[3] Given Scotland's ageing population, the established links between age and long-term conditions are significant.[1] The link with deprivation, lifestyle factors and wider health determinants is also of importance in Scotland given its persistent health inequalities.ccix Long-term conditions therefore represent personal, social and economic costs both to individuals and their families and to Scottish society more widely.
8.1.1 Common long-term conditions included in the Scottish Health Survey (SHeS)
Respiratory diseases and metabolic disorders including cardiovascular disease (CVD), diabetes and hypertension are prominent physical long-term conditions. Together, they represent a significant health burden in Scotland, and globally.[4]
Asthma and chronic obstructive pulmonary disease (COPD) are common long-term respiratory diseases. Asthma is characterised by variable and recurring symptoms of breathlessness, wheezing, coughing and chest tightness. It is estimated that 385,000 people in Scotland are currently receiving treatment for asthma, 296,000 of which are children.[5]
COPD is a chronic lung condition caused by restricted airways resulting in breathing difficulties, persistent coughing and abnormal sputum production.[6] The breathing restrictions associated with COPD are a major cause of repeated hospital admissions in Scotland.[7] Estimates suggest that treating COPD costs the NHS in Scotland around £100 million a year.[7]
CVD is one of the leading contributors to the global disease burden.[4] Its main components are ischaemic heart disease (IHD) (or coronary heart disease) and stroke, both of which have been identified as clinical priorities for the NHS in Scotland.[8] IHD is the second most common cause of death in Scotland after cancer, accounting for 13% of deaths in 2013, with a further 8% caused by stroke.[9] Early mortality from heart disease and stroke have also both improved in recent years (surpassing targets in both cases), but concern remains about continuing inequalities in relation to morbidity and mortality linked to these conditions.[8]
The increasing prevalence of diabetes, the most common metabolic disorder, is a major health issue for Scotland. Scotland has one of the highest levels of type 1 diabetes in Europe, but it is the rising levels of type 2 diabetes - linked to obesity, physical inactivity and ageing - which are driving the increased prevalence and causing concern.[10] Diabetes is a risk factor in premature mortality, although there have been improvements in recent years.[10]
Hypertension, the presence of persistently raised blood pressure[11], is the second most important preventable risk factor for premature death.[12] SIGN guidance acknowledges the link between elevated blood pressure (BP) and increased risk of CHD, heart failure, stroke and renal failure.[13] Guidelines from The British Hypertension Society[14] indicate that various lifestyle activities are associated with a potential reduction in blood pressure including: weight reduction, increased physical activity, limited alcohol consumption, and a balanced diet high in fruit and vegetable consumption and low in total and saturated fat and salt.
8.1.2 Policy background
One of the Scottish Government's 15 National Performance Framework National Outcomes is for people in Scotland to 'live longer, healthier lives'.[15] There is also a National Performance indicator to 'reduce premature mortality' (deaths from all causes in those aged under 75).[16] CVD is described as one of the key 'big killer' diseases around which action must be taken if this target is to be met. COPD is another major cause of death in Scotland, hence COPD prevention and symptom management will also contribute to reducing premature mortality.[7] In addition, a number of the national indicators [17]are linked to key CVD and respiratory disease risk factors, most notably smoking,[18] but also physical activity[19] and obesity.[20]
In recognition of the challenges posed by long-term conditions - both for the individual and their families, as well as for health and care services - the Scottish Government's over-arching strategy for long-term conditions was published in 2009. Delivering on a commitment made in the earlier Better Health, Better Care: Action Plan[21], the Action Plan recognised the need for system-wide action in response to the challenge presented by the increasing prevalence of long-term conditions within the context of an ageing population, the links to health inequalities, and the particular challenges of multi-morbidity - the experience of two or more long-term conditions.
8.1.3 Reporting on long-term conditions in SHeS
SHeS is an important source of information on the prevalence of long-term conditions in Scotland. It also offers valuable information on the patterning of conditions across different groups in society. In this chapter trends in self-reported long-term conditions prevalence for adults and children are updated. Prevalence of specific long-term conditions including: respiratory conditions (asthma and COPD); CVD; diabetes; and hypertension are also reported. Updated trends in adult hypertension are presented and the extent of diagnosis, treatment and control of hypertension are also explored. Supplementary tables will also be available on the Scottish Government SHeS website.[22]
8.2 METHODS AND DEFINITIONS
Self-reported long-term conditions
All participants were asked if they had any physical or mental health condition or illness lasting - or likely to last - for twelve months or more. Those who reported having such a condition were asked to provide more details about it. Answers were recorded verbatim and then coded in the office. Those reporting a condition were also asked if it limited their daily activities a lot, a little, or not at all. This enabled conditions to be classified as either 'limiting' or 'non-limiting'. These questions did not specify that conditions had to be doctor-diagnosed; responses were thus based on individuals' perceptions. As the question wording differs slightly from that used in the 2008 to 2011 surveys, time series data should be interpreted with caution.
Asthma and COPD
Participants were asked if a doctor had ever told them they had asthma. Participants were also asked if they had ever had COPD, chronic bronchitis or emphysema, and if so, whether a doctor had told them they had one of these conditions. No objective measures were used to confirm these self-reported diagnoses.
Self-reported doctor-diagnosed disease
Participants were asked whether they had ever suffered from any of the following conditions: diabetes, angina, heart attack, stroke, heart murmur, irregular heart rhythm, 'other heart trouble'. If they responded affirmatively, participants were asked whether they had ever been told they had the condition by a doctor. For the purposes of the analysis presented in this chapter, participants were only classified as having a particular condition if they reported that the diagnosis had been confirmed by a doctor. Participants were also asked if symptoms of the condition had occurred within the past 12 months. No distinction was made between type 1 and type 2 diabetes in the interview. Women whose diabetes occurred only during pregnancy were excluded from the analysis.
It is important to note that no attempt was made to verify these self-reported diagnoses objectively. It is therefore possible that some misclassification may have occurred because some participants may not have remembered (or not remembered correctly) the diagnosis made by their doctor.
Blood pressure
Blood pressure was measured during the biological module,[23] using the Omron HEM207 device. This equipment has been used on SHeS since 2003. Prior to 2012, blood pressure was collected in a follow-up interview conducted by the survey nurses. The nurse interview was discontinued in 2012, and since then specially trained interviewers have been collecting some of the less complex measures and samples previously collected by nurses, as part of the biological module. The equipment and protocol for taking blood pressure readings did not change. A validation study was carried out to assess the impact of the switch from nurse to interviewer administration.[24]
Three blood pressure readings were taken from consenting participants at one minute intervals using an appropriately sized cuff and on the right arm where possible. Participants were in a seated position and readings were taken after a five minute rest. Systolic and diastolic pressures and pulse measurements were displayed on the Omron for each measure. As in previous years, pregnant participants were excluded.
Since the size of the cuff used when taking blood pressure readings is an important factor in ensuring that accurate measurements are obtained three different sizes of cuff were available for use. Full details of the protocol used to take blood pressure reading in the survey are available in Volume 2 of this report.
The blood pressure measures used in this chapter are the means of the second and third measurements obtained for those whom three readings were successful obtained. Analyses exclude results from participants who had eaten, drunk alcohol, smoked or exercised in the 30 minutes before the measurement was taken.
Use of medication
During the biological module, participants were asked about all the prescribed medications they were currently taking (i.e. taken in the last seven days). During the data processing phase, medications are coded according to the classification in the British National Formulary (BNF), and from this classification it is possible to identify lipid-lowering and anti-platelet medication. Some analyses in this chapter examine the effect of use of these drugs.
Any CVD condition
Participants were classified as having 'any CVD' if they reported ever having any of the following conditions confirmed by a doctor: angina, heart attack, stroke, heart murmur, abnormal heart rhythm, or 'other heart trouble'.[25]
Any CVD condition or diabetes
A second category of the above conditions and diabetes is also presented in the tables as 'any CVD condition or diabetes'.
Ischaemic heart disease (IHD)
Participants were classified as having IHD if they reported ever having angina or a heart attack confirmed by a doctor. All tables refer to ever having the condition.
Ischaemic heart disease (IHD) or stoke
Participants were classified as having IHD or stroke if they reported ever having angina, or a heart attack, or a stroke, confirmed by a doctor.
Blood pressure levels classification
In accordance with guidelines on hypertension management[14] the threshold of 140/90mmHg is used to define hypertension in SHeS.
Adult participants were classified into one of four groups listed below on the basis of their systolic (SBP) and diastolic (DBP) readings and their current use of anti-hypertensive medications. For the purpose of this report, the term 'hypertensive' is applied to those in the last three categories.
| Normotensive untreated |
SBP below 140mmHg and DBP below 90mmHg, not currently taking medication specifically prescribed to treat high blood pressure |
| Hypertensive controlled |
SBP below 140mmHg and DBP below 90mmHg, currently taking medication specifically prescribed to treat high their blood pressure |
| Hypertensive uncontrolled |
SBP at least 140mmHg or DBP at least 90mmHg, currently taking medication specifically prescribed to treat their high blood pressure |
| Hypertensive untreated |
SBP at least 140mmHg or DBP at least 90mmHg, not currently taking a drug specifically prescribed to treat their high blood pressure |
Detection, treatment and control of hypertension
In addition to the objective definition of hypertension described above, participants were defined as having self-reported doctor-diagnosed hypertension if they stated during the interview that they had been told by a doctor or nurse that they had high blood pressure.
Hypertension detection was estimated by examining the proportion of those with survey defined hypertension (SBP at least 140mmHg or DBP at least 90 mmHg or on treatment for hypertension) reporting doctor-diagnosed hypertension. Treatment rates were estimated by examining the proportion of all those defined as having survey-defined hypertension who were on treatment at the time of the survey. The control of hypertension among those on treatment for hypertension at the time of the survey was estimated by calculating the proportion with blood pressure below 140/90mmHg.
When interpreting results it should be borne in mind that although three blood pressure readings were taken, these were all on a single occasion. Clinical diagnosis of hypertension are based on sustained levels of high blood pressure rather than a single measurement.
8.3 LONG-TERM CONDITIONS
8.3.1 Trends in long-term conditions prevalence in adults since 2008
In 2013, 44% of adults reported having a long-term condition. Around one in three (31%) had a condition that limited their daily activities in some way, while 13% reported that they had a condition that was non-limiting. As seen in previous years, women were more likely than men to report having a long-term condition (46% compared with 41%). The difference between the sexes is explained by a higher prevalence of limiting conditions among women (34% compared with 28% in men), whereas the proportion with a non-limiting condition was the same for men and women (13%).
It was noted in the 2012 annual report that the proportion of adults with a long-term condition had increased significantly since 2008 (from 41% to 46%).[26] There was, however, no significant change in prevalence between 2012 and 2013 (46% and 44% respectively). The trend for limiting conditions has been similar to that observed for long-term conditions more generally, while prevalence of non-limiting conditions has remained relatively stable since 2008 (15% in 2008 and 13% in 2013).
For women, long-term conditions trends have been similar to those observed for all adults. Both the percentage with a long-term condition, and the percentage with a limiting condition, increased between 2008 and 2012 (in 2008, 42% had a long-term condition and 28% had a limiting condition; by 2012 these had increased to 49% and 35% respectively), with no significant change since then (in 2013 46% had a long-term condition and 34% had a limiting condition). For men, there has been a smaller increase in long-term condition prevalence over the years (38% in 2008 and 42% in 2012) with no significant changes observed between 2012 and 2013 (42% and 41%). Table 8.1
8.3.2 Trends in long-term conditions prevalence in children since 2008
In 2013, around one in six (17%) children aged 0-15 had a long-term condition. Nine percent had a long-term condition that limited their activities in some way, while 8% reported having a non-limiting condition. In line with findings from previous years, boys were significantly more likely than girls to have a long-term condition (19% compared with 15%).
The proportion of children with a long-term condition has fluctuated between 14% and 17% since 2008, with no significant change in more recent years (16% in 2012 and 17% in 2013). Similar patterns were observed for trends in both limiting and non-limiting conditions prevalence in children.
Since 2008 there has been a statistically significant increase in the proportion of boys reporting a long-term condition (from 15% to 19%). The increase has largely been driven by an increase in the percentage reporting the presence of limiting condition (from 7% to 11% in 2013). Long-term condition prevalence has not changed significantly for girls over the years (14% in 2008 and 15% in 2013) and the change observed between 2012 and 2013 (12% in 2012 and 15% in 2013) was not statistically significant. Figure 8A, Table 8.2
8.4 ASTHMA
8.4.1 Trends in asthma prevalence in adults since 1998
In 2013, around one in six (16%) adults aged 16 and above reported that they had been diagnosed with asthma by a doctor, either recently or in the past. A similar percentage (18%) reported that they had experienced wheezing in the 12 months prior to interview. Neither doctor-diagnosed asthma nor wheezing prevalence varied significantly by sex in 2013 (16% of men and 17% of women had asthma that had been diagnosed by a doctor; and 17% of men and 19% of women reported wheezing in the previous 12 months).
In the 2012 annual report it was noted that there had been a steady increase in doctor-diagnosed asthma among those aged 16-74 since 1998 (from 11% to 17%).[26] In 2013, asthma prevalence was at the same level as in 2012 (17%).
Reported wheezing among adults aged 16-74 has changed little since 1998 (16% in 1998 and 18% in 2013). While prevalence for men aged 16-74 has followed a similar pattern to that observed for all adults, there has been a gradual statistically significant increase in the percentage of women aged 16-74 reporting that they experienced wheezing in the 12 months prior to interview (15% in 1998 and 20% in 2013).
Trends are also available for all adults aged 16 and above from 2003 onwards. The patterns observed here were largely similar to those discussed above for those aged 16-74. In the last decade there has been a gradual increase in doctor-diagnosed asthma in adults aged 16 and above (from 13% in 2003 to 16% in 2013) but no significant change in more recent years. While reported wheezing has not changed significantly since 2003 for either all adults or just men, there has been a statistically significant increase in the percentage of women reporting experiencing wheezing in the 12 months prior to interview (from 16% in 2003 to 19% in 2013). Table 8.3
8.4.2 Trends in asthma prevalence in children since 1998
In 2013, 13% of children aged 0-15 had been diagnosed with asthma by a doctor. A similar percentage (14%) reported experiencing wheezing in the 12 months prior to interview. While it appears that a higher proportion of boys than girls had been diagnosed with asthma (15% compared with 12%), this difference was not statistically significant. Boys were, however, significantly more likely than girls to have experienced wheezing in the previous year (17% compared with 12%).
In the 2012 report it was noted that between 1998 and 2012 there had been a decrease in doctor-diagnosed asthma among children aged 2-15 (from 18% to 13%).[26] The two percentage point increase in prevalence between 2012 and 2013 was not a statistically significant change. Similarly, the observed increase in prevalence among girls aged 2-15, between 2012 and 2013 (from 10% to 13%), did not represent a statistically significant change. Among boys of the same age, asthma prevalence has not changed significantly since 2008/2010 combined (15% in 2008/2010 and 16% in 2013).
There was some evidence of a small decline, since 1998 (16%), in the proportion of children aged 2-15 experiencing wheezing in the year prior to interview, but with little change in more recent years (13% in both 2012 and 2013). Table 8.3
8.5 CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
8.5.1 Trends in COPD prevalence since 2008
In 2013, 4% of adults aged 16 and above reported that they had been diagnosed with COPD by a doctor. Reported diagnosis was similar for men and women (3% and 4%, respectively). COPD prevalence has not changed significantly since the questions were introduced to the survey in 2008 (3% for men in both 2008 and 2013, and 4% for women in these same years). Table 8.4
8.6 CARDIOVASCULAR CONDITIONS AND DIABETES
8.6.1 Trends in any CVD, and CVD or diabetes prevalence since 1995
Any CVD
In 2013, 15.5% of adults aged 16 and above reported being diagnosed with any CVD condition by a doctor. Reported diagnosis levels did not vary significantly between men and women (15.7% and 15.3% respectively). In the 2012 annual report it was noted that there had been a small gradual increase in the proportion of men and women aged 16-64 with any CVD condition since 1995.[26] This trend was less apparent when 2013 data were included. Prevalence in 2013 was not significantly different from that in either 1995 or in 2012, for either men (8.4% in 1995, 10.3% in 2012 and 9.3% in 2013) or women (8.9% in 1995, 11.3% in 2012 and 10.6% in 2013) aged 16-64.
While prevalence levels were higher for all those aged 16 and above, reflecting the higher prevalence at older ages, the trend since 2003 has been similar to that discussed above for those aged 16-64. Table 8.5
Any CVD or diabetes
In 2013, 18.9% of adults aged 16 and above had any CVD condition or diabetes (19.2% of men and 18.6% of women). The trend in any CVD or diabetes prevalence for those aged 16-64 has been very similar to that discussed above for any CVD, a small increase since 1995 with no significant change between 2012 and 2013 for either men or women. Figures for 2013 remain significantly higher than those for 1995, due to changes in diabetes prevalence discussed below. A similar pattern was observed for all adults aged 16 and above since 2003. Table 8.5
Doctor-diagnosed diabetes prevalence
In 2013, 5.6% of adults aged 16 and above reported that they had been diagnosed with diabetes by a doctor (6.1% of men and 5.1% of women). The percentage of adults aged 16-64 with a diagnosis doubled between 1995 and 2013 (1.5% and 3.1% respectively), although levels in 2013 were no different from those in 2008. Prevalence declined, but not significantly, between 2012 and 2013 for both men and women. In 2013, the percentage of men and women aged 16-64 with a diabetes diagnosis (3.4% and 2.9%, respectively) was similar to the 2008 levels for both sexes (3.3% and 2.8%, respectively). There has been a small steady increase in the percentage of all adults aged 16 and above reporting that a doctor diagnosed them with diabetes (3.7% in 2003 to 5.6% in 2013). Table 8.5
8.6.2 Trends in IHD, stroke, and IHD or stroke prevalence since 1995
IHD
In 2013, 6.1% of adults aged 16 and above had IHD, with reported diagnosis higher for men than for women (7.1% compared with 5.3%). In 1995, 4.0% of men and 2.9% of women aged 16-64 had IHD, the equivalent figures in 2013 were 2.8% and 1.8% respectively. There has also been a very small decrease in the proportion of adults aged 16 and above with IHD since 2003 (from 7.3% to 6.1% in 2013).
Stroke
In 2013, 2.9% of adults aged 16 and above reported having had a stroke. Prevalence did not vary significantly between men and women (3.2% and 2.7%). The proportion of adults aged 16-64 reporting having had a stroke was at its highest level in 2013 (1.6% compared with 0.8% in 1995 and 0.6% in 1998), with a three-fold increase in prevalence among women this age since 1995 (0.5% compared with 1.5% in 2013). Since 2003 the percentage of all adults aged 16 and above reporting a doctor-diagnosed stroke has increased by 0.7 percentage points (from 2.2% to 2.9%).
IHD or stroke
Around one in twelve (8.3%) adults aged 16 and above reported that they had ever had IHD or a stroke in 2013 (9.5% of men and 7.2% of women). As reported in the 2012 annual report, since 1995 there has been very little change in IHD or stroke prevalence among 16-64 year olds (3.9% in 1995 and 3.7% in 2013).ccxxxiv A similar pattern was observed for adults aged 16 and above since 2003 (8.8% in 2003 and 8.4% in 2013). Table 8.5
8.7 HYPERTENSION
8.7.1 Blood pressure levels in 2012/2013 combined, by age and sex
Four categories have been used to classify hypertension in Table 8.6, drawing a distinction between those with normal blood pressure who are or are not receiving any treatment for hypertension and those with raised blood pressure (survey defined high blood pressure) who are or are not receiving treatment. These latter two groups are important target groups in the population. The first (those with raised blood pressure who are receiving treatment) includes people with potentially poorly managed hypertension, while the second provides an estimate of the prevalence of potentially undiagnosed cases of this condition. It should be noted, when considering this last category, that not everyone with a one-off raised blood pressure measurement actually has hypertension on repeated measurement; the definition of hypertension is 'sustained raised BP'. Nor does everyone with a blood pressure of 140-159/90-99mmHg warrant treatment, which is indicated for people aged under 80 with existing CVD, diabetes, damage from raised blood pressure (e.g. kidney disease) or at high risk of developing CVD.
The prevalence of survey-defined hypertension (blood pressure of >140/90 mmHg and/or taking anti-hypertensive medication) in 2012/2013 was 29.1%. Increasing age was a major risk factor for hypertension, with prevalence ranging from 10.4% of men and 1.6% of women aged 16-24, up to 51.3% of men and 71.8% of women aged 75 and over. For those aged under 35, survey-defined hypertension was significantly higher among men than women, whereas the opposite was true for those aged 65 and over.
With the exception of those aged 65 and above, more than half the cases of survey-defined hypertension in men were untreated. For women, more than half the cases in those aged under 55 were untreated. No survey participants under the age of 35 were being treated for hypertension. For both men and women, treated hypertension (both controlled and uncontrolled) increased with age up to age 55-64. While treatment rates did not continue to increase significantly above this age for men (27% of men aged 75 and above received treatment), they did so for women (41% of women aged 65-74 and 42% of women aged 75 and above). Where hypertension was treated, it remained uncontrolled in more than half of cases for both men and women. Figure 8B, Figure 8C, Table 8.6
8.7.2 Trends in blood pressure levels since 1998
Blood pressure readings have been collected in SHeS since 1995. However, since information on medications to treat high blood pressure has only been collected in the interview since 1998, the 1995 trend data is not presented here. Trends in blood pressure should be interpreted with caution for two reasons. In 2003 the equipment used to take blood pressure changed for both SHeS and the Health Survey for England (HSE). A small calibration exercise was carried out by the HSE at the time to determine the impact of the equipment change. In addition, since 2012 blood pressure readings have been taken by specially trained interviewers. Prior to this survey nurses collected blood pressure as part of the follow-up nurse interview. Again, a calibration study was carried out to determine the impact of the switch from survey nurses to interviewers (see Section 8.2.1 for further details). Calibrated estimates for 1998 and 2012/2013 are presented in Table 8.7. For 2012/2013, the unadjusted measurements collected by interviewers are also presented. Adjusted estimates should be used for 2012/2013 when interpreting trend data.
Participants were recorded as having 'survey-defined hypertension' in SHeS if they had either high blood pressure readings or were on medication to control blood pressure (see Section 8.2.2). The proportion of adults aged 16-74 with survey-defined hypertension increased significantly between 1998 and 2003 and then remained relatively stable until 2012/2013 when it dropped, although not significantly, to 24.9% (based on adjusted estimates). As a result, in 2012/2013 hypertension levels among 16-74 year olds were not significantly different from those observed in 1998. While trends for men and women followed a similar pattern, the changes were slightly more pronounced for men. Although the decline between 2010/2011 and 2012/2013 was not statistically significant for either men or women aged 16-74.
Survey-defined hypertension remained stable for adults aged 16 and over between 2003 and 2010/2011 (32.5-32.9%), before a statistically significant decline to 28.4% (based on adjusted estimates) in 2012/2013. Similar patterns were observed for men and women separately. Table 8.7
8.7.3 Comparison of doctor-diagnosed hypertension with survey-defined hypertension in 2012/2013 combined, by age and sex
Participants were asked if they have, or ever had, high blood pressure. Those who said "yes" were asked whether they were told by a doctor or nurse that they had high blood pressure. Those who said "yes" to this question were recorded as having "doctor-diagnosed" hypertension (unless they only had high blood pressure while pregnant).
In 2012/2013, there was a significant difference between doctor-diagnosed hypertension for adults and survey-defined hypertension: 22.8% reported having been told by a doctor they had hypertension (either recently, or in the past), compared with 29.1% with survey-defined hypertension. The difference between doctor-diagnosed and survey-defined hypertension was slighter larger for men than women (difference of 7.4 percentage points, compared with 5.3 points for women).
Across age groups it was generally, although not exclusively, the case that the prevalence of doctor-diagnosed hypertension was lower than that of survey-defined hypertension. The difference was particularly apparent among women aged 55 and over and men aged 55-74. For example, there was a 15 percentage point difference between doctor-diagnosed hypertension and survey defined hypertension for men aged 55-64 and a 17 percentage point difference for women aged 75 and over. Interestingly, there was no difference between doctor-diagnosed and survey defined hypertension for men aged 75 and over. At the other end of the age spectrum for men, just 0.5% aged 16-24 reported doctor-diagnosed hypertension, yet one in ten (10.4%) had survey-defined hypertension. The exception was among women aged 16-44, for whom survey-defined hypertension was slightly lower than doctor-diagnosed levels. Figure 8D, Figure 8E, Table 8.8
8.7.4 Detection and treatment of hypertension in 2012/2013 combined, by age and sex
The hypertension detection and treatment rates for 2012/2013 are shown in Table 8.9. The detection rate is defined as the proportion of participants with survey-defined hypertension who also had self-reported doctor-diagnosed hypertension. Two treatment rates are presented, 'hypertension treated but not controlled' is defined as the proportion of participants with survey-defined hypertension who also reported being on treatment for their blood pressure. Whereas, 'hypertension treated and controlled' is the proportion of participants with survey-defined hypertension who did not have survey-defined high blood pressure. Detection and treatment rates for those aged 16-34 are not shown due to the low prevalence of hypertension in this age group.
The detection rate for adults aged 16 and above in 2012/2013 was 58%, with a significantly higher detection rate for women than for men (65% compared with 50%). While detection rates appeared to vary with age, these differences were not significant due to the small sample sizes. Further years of data will be required to establish if detection rates do vary significantly by age in the population.
In 2012/2013, a quarter (25%) of those with survey-defined hypertension were receiving treatment for hypertension, but had high blood pressure according to their survey readings (uncontrolled hypertension). One in five (20%) of those with survey-defined hypertension were receiving treatment which maintained their blood pressure readings below the levels defined as high (controlled hypertension). Controlled and uncontrolled treatment rates did not vary significantly for men or women due to the small sample sizes. Table 8.9
Table list
Table 8.1 Prevalence of long-term conditions in adults, 2008 to 2013
Table 8.2 Prevalence of long-term conditions in children, 2008 to 2013
Table 8.3 Doctor-diagnosed asthma, 1998 to 2013, by age and sex
Table 8.4 Doctor-diagnosed COPD, 2008 to 2013
Table 8.5 Any CVD, any CVD or diabetes, doctor-diagnosed diabetes, IHD, stroke, IHD or stroke, 1995 to 2013
Table 8.6 Blood pressure level, 2012/2013 combined, by age and sex
Table 8.7 Blood pressure level, 1998 to 2012/2013 combined
Table 8.8 Comparison of doctor-diagnosed with survey-defined hypertension, 2012/2013 combined, by age and sex
Table 8.9 Detection and treatment of hypertension, 2012/2013 combined, by age and sex
Additional tables available on the survey website include:
- High blood pressure, angina, heart attack, heart murmur, abnormal heart rhythm or other heart trouble, by age & key demographics
- Any CVD, CVD or diabetes, diabetes, IHD, stroke, IHD or stroke, by age & key demographics
- High blood pressure & doctor diagnosed high blood pressure, by age & key demographics
- Angina & doctor diagnosed angina, by age & key demographics
- Heart attack & doctor diagnosed heart attack, by age & key demographics
- Heart murmur & doctor diagnosed heart murmur, by age & key demographics
- Abnormal heart rhythm & doctor diagnosed abnormal heart rhythm, by age & key demographics
- Any other heart trouble & doctor diagnosed other heart condition, by age & key demographics
- Stroke & doctor diagnosed stroke, by age & key demographics
- Diabetes & doctor diagnosed diabetes (excluding pregnant), by age & key demographics
- COPD & doctor diagnosed COPD, by age & key demographics
- Medication for heart or stroke, & high blood pressure by age & key demographics
- Talked to doctor in last two weeks (adults with/without CVD), by age & key demographics
- Last time talked to a doctor (adults with/without CVD), by age & key demographics
- Attended hospital in past year as outpatient (adults with/without CVD), by age & key demographics
- Hospital inpatient in last 12 months (adults with/without CVD), by age & key demographics
- Longstanding illness, type and severity, by age & key demographics
- Wheezing or whistling in the chest ever/in last 12 months, by age & key demographics
- Doctor diagnosed asthma, by age & key demographics
Table 8.1 Prevalence of long-term conditions in adults, 2008 to 2013
| Aged 16 and over |
|
2008 to 2013 | ||||
| Long-term conditions and limiting long-term conditions |
2008 |
2009 |
2010 |
2011 |
2012 |
2013 |
| % |
% |
% |
% |
% |
% |
|
| Men |
||||||
| No long-term conditions |
62 |
63 |
59 |
57 |
58 |
59 |
| Limiting long-term conditions |
23 |
23 |
25 |
26 |
28 |
28 |
| Non-limiting long-term conditions |
15 |
14 |
16 |
17 |
14 |
13 |
| Total with conditions |
38 |
37 |
41 |
43 |
42 |
41 |
| Women |
||||||
| No long-term conditions |
58 |
58 |
55 |
54 |
51 |
54 |
| Limiting long-term conditions |
28 |
27 |
30 |
30 |
35 |
34 |
| Non-limiting long-term conditions |
15 |
15 |
15 |
16 |
14 |
13 |
| Total with conditions |
42 |
42 |
45 |
46 |
49 |
46 |
| All adults |
||||||
| No long-term conditions |
59 |
60 |
57 |
56 |
54 |
56 |
| Limiting long-term conditions |
26 |
25 |
28 |
28 |
32 |
31 |
| Non-limiting long-term conditions |
15 |
14 |
16 |
16 |
14 |
13 |
| Total with conditions |
41 |
40 |
43 |
44 |
46 |
44 |
| Bases (weighted): |
||||||
| Men |
3087 |
3597 |
3465 |
3610 |
2306 |
2345 |
| Women |
3377 |
3926 |
3777 |
3932 |
2505 |
2545 |
| All adults |
6464 |
7523 |
7242 |
7542 |
4811 |
4889 |
| Bases (unweighted): |
||||||
| Men |
2840 |
3283 |
3112 |
3280 |
2125 |
2139 |
| Women |
3623 |
4241 |
4129 |
4262 |
2686 |
2752 |
| All adults |
6463 |
7524 |
7241 |
7542 |
4811 |
4891 |
Table 8.2 Prevalence of long-term conditions in children, 2008 to 2013
| Aged 0 - 15 |
|
2008 to 2013 | ||||
| Long-term conditions and limiting long-term conditions |
2008 |
2009 |
2010 |
2011 |
2012 |
2013 |
| % |
% |
% |
% |
% |
% |
|
| Boys |
||||||
| No long-term conditions |
85 |
82 |
83 |
85 |
81 |
81 |
| Limiting long-term conditions |
7 |
7 |
9 |
7 |
11 |
11 |
| Non-limiting long-term conditions |
8 |
11 |
8 |
9 |
8 |
9 |
| Total with conditions |
15 |
18 |
17 |
15 |
19 |
19 |
| Girls |
||||||
| No long-term conditions |
86 |
86 |
87 |
87 |
88 |
85 |
| Limiting long-term conditions |
6 |
6 |
7 |
5 |
6 |
8 |
| Non-limiting long-term conditions |
8 |
8 |
6 |
9 |
6 |
8 |
| Total with conditions |
14 |
14 |
13 |
13 |
12 |
15 |
| All children |
||||||
| No long-term conditions |
86 |
84 |
85 |
86 |
84 |
83 |
| Limiting long-term conditions |
6 |
6 |
8 |
6 |
9 |
9 |
| Non-limiting long-term conditions |
8 |
9 |
7 |
9 |
7 |
8 |
| Total with conditions |
14 |
16 |
15 |
14 |
16 |
17 |
| Bases (weighted): |
||||||
| Boys |
896 |
1333 |
916 |
1012 |
912 |
940 |
| Girls |
854 |
1273 |
875 |
969 |
873 |
897 |
| All children |
1750 |
2606 |
1791 |
1981 |
1786 |
1837 |
| Bases (unweighted): |
||||||
| Boys |
872 |
1333 |
960 |
995 |
878 |
948 |
| Girls |
878 |
1272 |
831 |
986 |
908 |
889 |
| All children |
1750 |
2605 |
1791 |
1981 |
1786 |
1837 |
Table 8.3 Doctor-diagnosed asthma, 1998 to 2013, by age and sex
| All persons |
|
1998 to 2013 | |||
| Respiratory symptoms and asthma |
1998 |
2003 |
2008/2010 combined |
2012 |
2013 |
| % |
% |
% |
% |
% |
|
| Males |
|||||
| Wheezed in last 12 monthsa |
|||||
| 0-15 |
n/a |
16 |
14 |
15 |
17 |
| 2-15 |
16 |
16 |
14 |
15 |
16 |
| 16-74 |
16 |
16 |
14 |
17 |
16 |
| 16+ |
n/a |
16 |
14 |
17 |
17 |
| Doctor-diagnosed asthma |
|||||
| 0-15 |
n/a |
20 |
14 |
15 |
15 |
| 2-15 |
19 |
21 |
15 |
17 |
16 |
| 16-74 |
11 |
13 |
13 |
16 |
16 |
| 16+ |
n/a |
13 |
13 |
16 |
16 |
| Females |
|||||
| Wheezed in last 12 monthsa |
|||||
| 0-15 |
n/a |
12 |
11 |
11 |
12 |
| 2-15 |
14 |
11 |
10 |
11 |
11 |
| 16-74 |
15 |
16 |
16 |
18 |
20 |
| 16+ |
n/a |
16 |
16 |
18 |
19 |
| Doctor-diagnosed asthma |
|||||
| 0-15 |
n/a |
12 |
12 |
9 |
12 |
| 2-15 |
16 |
14 |
14 |
10 |
13 |
| 16-74 |
12 |
14 |
16 |
17 |
18 |
| 16+ |
n/a |
14 |
15 |
17 |
17 |
| All |
|||||
| Wheezed in last 12 monthsa |
|||||
| 0-15 |
n/a |
14 |
12 |
13 |
14 |
| 2-15 |
16 |
13 |
12 |
13 |
13 |
| 16-74 |
16 |
16 |
15 |
18 |
18 |
| 16+ |
n/a |
16 |
15 |
18 |
18 |
| Doctor-diagnosed asthma |
|||||
| 0-15 |
n/a |
16 |
13 |
12 |
13 |
| 2-15 |
18 |
18 |
14 |
13 |
15 |
| 16-74 |
11 |
13 |
14 |
17 |
17 |
| 16+ |
n/a |
13 |
14 |
16 |
16 |
| Bases (weighted): |
|||||
| Males 0-15 |
n/a |
1701 |
960 |
914 |
939 |
| Males 2-15 |
1096 |
1516 |
841 |
803 |
830 |
| Males 16-74 |
4423 |
3588 |
2068 |
2136 |
2164 |
| Males 16+ |
n/a |
3847 |
2228 |
2309 |
2343 |
| Females 0-15 |
n/a |
1623 |
917 |
873 |
899 |
| Females 2-15 |
1046 |
1449 |
786 |
760 |
788 |
| Females 16-74 |
4577 |
3821 |
2178 |
2243 |
2282 |
| Females 16+ |
n/a |
4290 |
2432 |
2506 |
2546 |
| All 0-15 |
n/a |
3322 |
1877 |
1786 |
1838 |
| All 2-15 |
2142 |
2963 |
1627 |
1563 |
1618 |
| All adults 16-74 |
8996 |
7409 |
4247 |
4380 |
4446 |
| All adults 16+ |
n/a |
8137 |
4660 |
4815 |
4889 |
| Bases (unweighted): |
|||||
| Males 0-15 |
n/a |
1656 |
994 |
879 |
947 |
| Males 2-15 |
1987 |
1465 |
867 |
764 |
819 |
| Males 16-74 |
3941 |
3277 |
1801 |
1902 |
1920 |
| Males 16+ |
n/a |
3603 |
1999 |
2127 |
2137 |
| Females 0-15 |
n/a |
1668 |
883 |
907 |
891 |
| Females 2-15 |
1905 |
1468 |
746 |
785 |
763 |
| Females 16-74 |
5106 |
4043 |
2360 |
2362 |
2446 |
| Females 16+ |
n/a |
4536 |
2659 |
2688 |
2752 |
| All 0-15 |
n/a |
3322 |
1877 |
1786 |
1838 |
| All 2-15 |
3892 |
2931 |
1613 |
1549 |
1582 |
| All adults 16-74 |
9042 |
7320 |
4161 |
4264 |
4366 |
| All adults 16+ |
n/a |
8139 |
4658 |
4815 |
4889 |
a Wheezing or whistling in the chest
Table 8.4 Doctor-diagnosed COPD, 2008 to 2013
| Aged 16 and over |
|
2008 to 2013 | ||||
| Doctor-diagnosed COPD |
2008 |
2009 |
2010 |
2011 |
2012 |
2013 |
| % |
% |
% |
% |
% |
% |
|
| Men |
||||||
| Yes |
3 |
3 |
4 |
3 |
4 |
3 |
| No |
97 |
97 |
96 |
97 |
96 |
97 |
| Women |
||||||
| Yes |
4 |
4 |
5 |
4 |
4 |
4 |
| No |
96 |
96 |
95 |
96 |
96 |
96 |
| All adults |
||||||
| Yes |
4 |
3 |
5 |
4 |
4 |
4 |
| No |
96 |
97 |
95 |
96 |
96 |
96 |
| Bases (weighted): |
||||||
| Men |
3088 |
3601 |
3468 |
3609 |
2309 |
2347 |
| Women |
3377 |
3929 |
3777 |
3931 |
2506 |
2547 |
| All adults |
6465 |
7530 |
7245 |
7540 |
4815 |
4894 |
| Bases (unweighted): |
||||||
| Men |
2842 |
3288 |
3115 |
3279 |
2127 |
2140 |
| Women |
3623 |
4242 |
4130 |
4261 |
2688 |
2754 |
| All adults |
6465 |
7530 |
7245 |
7540 |
4815 |
4894 |
Table 8.5 Any CVD, any CVD or diabetes, doctor-diagnosed diabetes, IHD, stroke, IHD or stroke, 1995 to 2013
| Aged 16 and over |
1995 to 2013 | ||||||||
| Any CVDa / any CVD or diabetes / doctor-diagnosed diabetesb / IHDc / stroke / IHD or stroke |
1995 |
1998 |
2003 |
2008 |
2009 |
2010 |
2011 |
2012 |
2013 |
| % |
% |
% |
% |
% |
% |
% |
% |
% |
|
| Men |
|||||||||
| Any CVD |
|||||||||
| 16-64 |
8.4 |
8.1 |
9.7 |
9.9 |
9.5 |
10.5 |
9.8 |
10.3 |
9.3 |
| 16+ |
n/a |
n/a |
14.9 |
15.1 |
15.2 |
16.3 |
15.6 |
16.6 |
15.7 |
| Any CVD or diabetes |
|||||||||
| 16-64 |
9.4 |
9.7 |
11.1 |
12.2 |
12.7 |
13.6 |
12.7 |
13.0 |
12.0 |
| 16+ |
n/a |
n/a |
16.8 |
18.2 |
19.0 |
20.1 |
19.2 |
20.1 |
19.2 |
| Doctor-diagnosed diabetes |
|||||||||
| 16-64 |
1.5 |
2.2 |
2.4 |
3.3 |
4.7 |
4.5 |
4.0 |
4.1 |
3.4 |
| 16+ |
n/a |
n/a |
3.8 |
5.3 |
6.2 |
6.3 |
6.1 |
6.2 |
6.1 |
| IHD |
|||||||||
| 16-64 |
4.0 |
4.0 |
4.1 |
3.2 |
3.6 |
3.4 |
3.4 |
3.3 |
2.8 |
| 16+ |
n/a |
n/a |
8.2 |
6.9 |
7.4 |
7.5 |
7.5 |
7.3 |
7.1 |
| Stroke |
|||||||||
| 16-64 |
1.0 |
0.7 |
1.2 |
1.1 |
1.1 |
1.8 |
1.3 |
1.0 |
1.7 |
| 16+ |
n/a |
n/a |
2.4 |
2.5 |
2.7 |
3.3 |
2.9 |
2.8 |
3.2 |
| IHD or stroke |
|||||||||
| 16-64 |
4.6 |
4.4 |
5.0 |
4.2 |
4.4 |
4.8 |
4.3 |
4.0 |
4.3 |
| 16+ |
n/a |
n/a |
9.6 |
8.7 |
9.4 |
9.8 |
9.4 |
9.2 |
9.5 |
| Women |
|||||||||
| Any CVD |
|||||||||
| 16-64 |
8.9 |
8.5 |
8.9 |
10.7 |
9.0 |
9.3 |
8.4 |
11.3 |
10.6 |
| 16+ |
n/a |
n/a |
14.5 |
15.5 |
13.7 |
14.0 |
13.8 |
15.9 |
15.3 |
| Any CVD or diabetes |
|||||||||
| 16-64 |
10.1 |
9.6 |
10.2 |
12.8 |
11.2 |
11.3 |
10.8 |
13.9 |
13.0 |
| 16+ |
n/a |
n/a |
16.4 |
18.2 |
16.5 |
16.7 |
17.0 |
19.3 |
18.6 |
| Doctor-diagnosed diabetes |
|||||||||
| 16-64 |
1.5 |
1.8 |
2.0 |
2.8 |
2.9 |
2.8 |
3.2 |
3.4 |
2.9 |
| 16+ |
n/a |
n/a |
3.7 |
4.1 |
4.5 |
4.4 |
4.9 |
4.9 |
5.1 |
| IHDb |
|||||||||
| 16-64 |
2.9 |
2.7 |
2.6 |
2.2 |
1.9 |
2.2 |
1.8 |
2.3 |
1.8 |
| 16+ |
n/a |
n/a |
6.5 |
5.6 |
5.2 |
5.2 |
4.9 |
5.7 |
5.3 |
| Stroke |
|||||||||
| 16-64 |
0.5 |
0.6 |
0.7 |
1.2 |
0.9 |
1.1 |
1.0 |
1.5 |
1.5 |
| 16+ |
n/a |
n/a |
2.1 |
2.8 |
2.2 |
2.5 |
2.7 |
2.8 |
2.7 |
| IHD or stroke |
|||||||||
| 16-64 |
3.2 |
3.0 |
3.2 |
3.1 |
2.4 |
3.1 |
2.6 |
3.5 |
3.1 |
| 16+ |
n/a |
n/a |
8.0 |
7.5 |
6.7 |
7.0 |
6.7 |
7.7 |
7.2 |
| All adults |
|||||||||
| Any CVD |
|||||||||
| 16-64 |
8.7 |
8.4 |
9.3 |
10.3 |
9.3 |
9.9 |
9.1 |
10.8 |
10.0 |
| 16+ |
n/a |
n/a |
14.7 |
15.3 |
14.4 |
15.1 |
14.6 |
16.2 |
15.5 |
| Any CVD or diabetes |
|||||||||
| 16-64 |
9.8 |
9.7 |
10.6 |
12.5 |
11.9 |
12.4 |
11.8 |
13.5 |
12.5 |
| 16+ |
n/a |
n/a |
16.6 |
18.2 |
17.7 |
18.3 |
18.1 |
19.7 |
18.9 |
| Doctor-diagnosed diabetes |
|||||||||
| 16-64 |
1.5 |
1.8 |
2.2 |
3.1 |
3.8 |
3.7 |
3.6 |
3.7 |
3.1 |
| 16+ |
n/a |
n/a |
3.7 |
4.6 |
5.3 |
5.3 |
5.5 |
5.5 |
5.6 |
| IHDb |
|||||||||
| 16-64 |
3.5 |
3.3 |
3.3 |
2.7 |
2.7 |
2.8 |
2.6 |
2.8 |
2.3 |
| 16+ |
n/a |
n/a |
7.3 |
6.2 |
6.2 |
6.3 |
6.2 |
6.5 |
6.1 |
| Stroke |
|||||||||
| 16-64 |
0.8 |
0.6 |
1.0 |
2.6 |
1.0 |
1.5 |
1.2 |
1.3 |
1.6 |
| 16+ |
n/a |
n/a |
2.2 |
2.6 |
2.5 |
2.9 |
2.8 |
2.8 |
2.9 |
| IHD or stroke |
|||||||||
| 16-64 |
3.9 |
3.7 |
4.0 |
3.6 |
3.4 |
3.9 |
3.5 |
3.7 |
3.7 |
| 16+ |
n/a |
n/a |
8.8 |
8.1 |
8.0 |
8.3 |
8.0 |
8.4 |
8.3 |
| Bases (weighted): |
|||||||||
| Men 16-64 |
3898 |
3953 |
3188 |
2542 |
2955 |
2837 |
2953 |
1885 |
1900 |
| Men 16+ |
n/a |
n/a |
3857 |
3086 |
3601 |
3465 |
3608 |
2308 |
2347 |
| Women 16-64 |
3988 |
3989 |
3327 |
2640 |
3068 |
2947 |
3069 |
1956 |
1978 |
| Women 16+ |
n/a |
n/a |
4291 |
3372 |
3926 |
3774 |
3931 |
2506 |
2545 |
| All adults 16-64 |
7886 |
7946 |
6517 |
5182 |
6023 |
5784 |
6023 |
3841 |
3878 |
| All adults 16+ |
n/a |
n/a |
8142 |
6459 |
7526 |
7240 |
7539 |
4814 |
4892 |
| Bases (unweighted): |
|||||||||
| Men 16-64 |
3520 |
3367 |
2771 |
2084 |
2408 |
2293 |
2423 |
1517 |
1605 |
| Men 16+ |
n/a |
n/a |
3610 |
2840 |
3287 |
3112 |
3277 |
2125 |
2140 |
| Women 16-64 |
4397 |
4212 |
3461 |
2694 |
3211 |
3083 |
3178 |
1974 |
2073 |
| Women 16+ |
n/a |
n/a |
4538 |
3618 |
4239 |
4127 |
4261 |
2688 |
2752 |
| All adults 16-64 |
7917 |
7583 |
6233 |
4778 |
5619 |
5376 |
5601 |
3491 |
3678 |
| All adults 16+ |
n/a |
n/a |
8142 |
6458 |
7526 |
7239 |
7538 |
4813 |
4892 |
a Any cardiovascular condition, excluding diabetes or high blood pressure
b Excludes diabetes diagnosed during pregnancy
c Heart attack or angina
Table 8.6 Blood pressure level, 2012/2013 combined, by age and sex
| Aged 16 and over and with a valid blood pressure reading and data on medication |
|
2012/2013 combined | ||||||
| Blood pressure level |
Age |
Total |
||||||
| 16-24 |
25-34 |
35-44 |
45-54 |
55-64 |
65-74 |
75+ |
||
| % |
% |
% |
% |
% |
% |
% |
% |
|
| Men |
||||||||
| Normotensive |
89.6 |
91.3 |
83.5 |
74.7 |
48.8 |
45.6 |
48.7 |
71.0 |
| Hypertensive controlled |
- |
- |
2.3 |
2.2 |
9.8 |
9.9 |
13.3 |
4.6 |
| Hypertensive uncontrolled |
- |
- |
1.7 |
4.5 |
11.8 |
14.4 |
13.4 |
5.8 |
| Hypertensive untreated |
10.4 |
8.7 |
12.5 |
18.6 |
29.6 |
30.1 |
24.6 |
18.6 |
| Total with hypertension |
10.4 |
8.7 |
16.5 |
25.3 |
51.2 |
54.4 |
51.3 |
29.0 |
| Women |
||||||||
| Normotensive |
98.4 |
97.7 |
89.4 |
74.9 |
55.5 |
33.6 |
28.2 |
70.8 |
| Hypertensive controlled |
- |
- |
0.9 |
6.4 |
12.5 |
16.8 |
18.2 |
7.2 |
| Hypertensive uncontrolled |
- |
- |
3.5 |
4.8 |
10.6 |
24.4 |
23.5 |
8.5 |
| Hypertensive untreated |
1.6 |
2.3 |
6.1 |
13.9 |
21.4 |
25.3 |
30.1 |
13.6 |
| Total with hypertension |
1.6 |
2.3 |
10.6 |
25.1 |
44.5 |
66.4 |
71.8 |
29.2 |
| All adults |
||||||||
| Normotensive |
94.2 |
94.5 |
86.5 |
74.8 |
52.3 |
39.3 |
37.0 |
70.9 |
| Hypertensive controlled |
- |
- |
1.6 |
4.3 |
11.2 |
13.5 |
16.1 |
5.9 |
| Hypertensive uncontrolled |
- |
- |
2.6 |
4.6 |
11.2 |
19.6 |
19.2 |
7.2 |
| Hypertensive untreated |
5.8 |
5.5 |
9.3 |
16.2 |
25.3 |
27.6 |
27.8 |
16.0 |
| Total with hypertension |
5.8 |
5.5 |
13.5 |
25.2 |
47.7 |
60.7 |
63.0 |
29.1 |
| Bases (weighted): |
||||||||
| Men |
116 |
130 |
149 |
169 |
136 |
106 |
72 |
879 |
| Women |
129 |
130 |
155 |
174 |
147 |
115 |
97 |
949 |
| All adults |
245 |
261 |
304 |
343 |
283 |
221 |
170 |
1828 |
| Bases (unweighted): |
||||||||
| Men |
88 |
105 |
132 |
146 |
130 |
143 |
84 |
828 |
| Women |
85 |
135 |
176 |
195 |
198 |
138 |
110 |
1037 |
| All adults |
173 |
240 |
308 |
341 |
328 |
281 |
194 |
1865 |
Table 8.7 Blood pressure level, 1998 to 2012/2013 combined
| Aged 16 and over and with a valid blood pressure reading and data on medication |
|
1998 to 2012/2013 combined | |||
| Blood pressure level |
1998 |
2003 |
2008/2009 combined |
2010/2011 combined |
2012/2013 combined |
| % |
% |
% |
% |
% |
|
| Men |
|||||
| Normotensive |
|||||
| 16-74 (nurse / nurse equivalent) |
77.7 |
70.6 |
68.1 |
70.1 |
73.8 |
| 16+ (nurse / nurse equivalent) |
n/a |
67.0 |
65.5 |
67.0 |
71.7 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
72.9 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
71.0 |
| Hypertensive controlled |
|||||
| 16-74 (nurse / nurse equivalent) |
3.0 |
5.3 |
7.6 |
6.0 |
3.8 |
| 16+ (nurse / nurse equivalent) |
n/a |
5.9 |
8.4 |
7.8 |
4.6 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
3.8 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
4.6 |
| Hypertensive uncontrolled |
|||||
| 16-74 (nurse / nurse equivalent) |
3.7 |
4.5 |
5.9 |
5.7 |
5.1 |
| 16+ (nurse / nurse equivalent) |
n/a |
6.3 |
6.9 |
6.7 |
5.8 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
5.1 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
5.8 |
| Hypertensive untreated |
|||||
| 16-74 (nurse / nurse equivalent) |
15.6 |
19.6 |
18.4 |
18.2 |
17.2 |
| 16+ (nurse / nurse equivalent) |
n/a |
20.7 |
19.2 |
18.5 |
17.8 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
18.1 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
18.6 |
| Total with hypertension |
|||||
| 16-74 (nurse / nurse equivalent) |
22.3 |
29.5 |
31.9 |
29.9 |
26.2 |
| 16+ (nurse / nurse equivalent) |
n/a |
33.0 |
34.5 |
33.0 |
28.3 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
27.1 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
29.0 |
| Women |
|||||
| Normotensive |
|||||
| 16-74 (nurse / nurse equivalent) |
78.8 |
73.3 |
73.5 |
73.4 |
76.4 |
| 16+ (nurse / nurse equivalent) |
n/a |
67.3 |
68.6 |
68.0 |
71.4 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
75.7 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
70.8 |
| Hypertensive controlled |
|||||
| 16-74 (nurse / nurse equivalent) |
4.4 |
6.0 |
7.0 |
6.1 |
6.1 |
| 16+ (nurse / nurse equivalent) |
n/a |
7.2 |
8.6 |
7.8 |
7.3 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
5.9 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
7.2 |
| Hypertensive uncontrolled |
|||||
| 16-74 (nurse / nurse equivalent) |
4.0 |
5.9 |
5.6 |
5.8 |
6.6 |
| 16+ (nurse / nurse equivalent) |
n/a |
9.0 |
8.2 |
8.6 |
8.3 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
6.7 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
8.5 |
| Hypertensive untreated |
|||||
| 16-74 (nurse / nurse equivalent) |
12.8 |
14.8 |
14.0 |
14.8 |
11.0 |
| 16+ (nurse / nurse equivalent) |
n/a |
16.6 |
14.7 |
15.7 |
12.9 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
11.7 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
13.6 |
| Total with hypertension |
|||||
| 16-74 (nurse / nurse equivalent) |
21.2 |
26.7 |
26.5 |
26.6 |
23.6 |
| 16+ (nurse / nurse equivalent) |
n/a |
32.7 |
31.4 |
32.0 |
28.6 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
24.3 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
29.2 |
| All adults |
|||||
| Normotensive |
|||||
| 16-74 (nurse / nurse equivalent) |
78.2 |
72.0 |
70.9 |
71.8 |
75.1 |
| 16+ (nurse / nurse equivalent) |
n/a |
67.2 |
67.1 |
67.5 |
71.6 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
74.3 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
70.9 |
| Hypertensive controlled |
|||||
| 16-74 (nurse / nurse equivalent) |
3.7 |
5.7 |
7.3 |
6.0 |
5.0 |
| 16+ (nurse / nurse equivalent) |
n/a |
6.6 |
8.5 |
7.8 |
6.0 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
4.9 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
5.9 |
| Hypertensive uncontrolled |
|||||
| 16-74 (nurse / nurse equivalent) |
3.8 |
7.8 |
5.7 |
5.7 |
5.9 |
| 16+ (nurse / nurse equivalent) |
n/a |
5.3 |
7.6 |
7.7 |
7.1 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
6.0 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
7.2 |
| Hypertensive untreated |
|||||
| 16-74 (nurse / nurse equivalent) |
14.2 |
17.1 |
16.1 |
16.5 |
14.0 |
| 16+ (nurse / nurse equivalent) |
n/a |
18.5 |
16.8 |
17.0 |
15.3 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
14.8 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
16.0 |
| Total with hypertension |
|||||
| 16-74 (nurse / nurse equivalent) |
21.8 |
28.0 |
29.1 |
28.2 |
24.9 |
| 16+ (nurse / nurse equivalent) |
n/a |
32.8 |
32.9 |
32.5 |
28.4 |
| 16-74 (interviewer) |
n/a |
n/a |
n/a |
n/a |
25.7 |
| 16+ (interviewer) |
n/a |
n/a |
n/a |
n/a |
29.1 |
| Bases (weighted): |
|||||
| Men 16-74 |
3356 |
1883 |
831 |
751 |
807 |
| Men 16+ |
n/a |
2032 |
899 |
815 |
879 |
| Women 16-74 |
3329 |
2101 |
889 |
785 |
851 |
| Women 16+ |
n/a |
2383 |
998 |
879 |
949 |
| All adults 16-74 |
3343 |
3985 |
1720 |
1536 |
1658 |
| All adults 16+ |
n/a |
4415 |
1897 |
1694 |
1828 |
| Bases (unweighted): |
|||||
| Men 16-74 |
3018 |
1726 |
748 |
653 |
744 |
| Men 16+ |
n/a |
1933 |
839 |
736 |
828 |
| Women 16-74 |
3709 |
2256 |
970 |
869 |
927 |
| Women 16+ |
n/a |
2538 |
1084 |
978 |
1037 |
| All adults 16-74 |
3364 |
3982 |
1718 |
1522 |
1671 |
| All adults 16+ |
n/a |
4471 |
1923 |
1714 |
1865 |
a Measurements were taken by an interviewer in 2012/13 and converted to an equivalent of the nurse measure
Table 8.8 Comparison of doctor-diagnosed with survey-defined hypertension, 2012/2013 combined, by age and sex
| Aged 16 and over |
|
2012/2013 combined | ||||||
| Hypertension |
Age |
Total |
||||||
| 16-24 |
25-34 |
35-44 |
45-54 |
55-64 |
65-74 |
75+ |
||
| % |
% |
% |
% |
% |
% |
% |
% |
|
| Men |
||||||||
| Self-reported doctor-diagnosed hypertensiona |
0.5 |
5.2 |
11.6 |
22.3 |
36.0 |
45.4 |
50.6 |
21.6 |
| Survey-defined hypertension |
10.4 |
8.7 |
16.5 |
25.3 |
51.2 |
54.4 |
51.3 |
29.0 |
| Women |
||||||||
| Self-reported doctor-diagnosed hypertensiona |
2.5 |
4.4 |
12.3 |
21.3 |
37.3 |
49.2 |
53.9 |
23.9 |
| Survey-defined hypertension |
1.6 |
2.3 |
10.6 |
25.1 |
44.5 |
66.4 |
71.8 |
29.2 |
| All adults |
||||||||
| Self-reported doctor-diagnosed hypertensiona |
1.5 |
4.8 |
12.0 |
21.8 |
36.7 |
47.4 |
52.5 |
22.8 |
| Survey-defined hypertension |
5.8 |
5.5 |
13.5 |
25.2 |
47.7 |
60.7 |
63.0 |
29.1 |
| Bases (weighted):b,c |
||||||||
| Men, self-reported doctor-diagnosed hypertension |
157 |
172 |
180 |
203 |
170 |
125 |
83 |
1091 |
| Men, survey-defined hypertension |
116 |
130 |
149 |
169 |
136 |
106 |
72 |
879 |
| Women, self-reported doctor-diagnosed hypertension |
155 |
180 |
191 |
215 |
177 |
141 |
123 |
1182 |
| Women, survey-defined hypertension |
129 |
130 |
155 |
174 |
147 |
115 |
97 |
949 |
| All adults, self-reported doctor-diagnosed hypertension |
313 |
352 |
371 |
418 |
347 |
266 |
206 |
2273 |
| All adults, survey-defined hypertension |
245 |
261 |
304 |
343 |
283 |
221 |
170 |
1828 |
| Bases (unweighted):b,c |
||||||||
| Men, self-reported doctor-diagnosed hypertension |
112 |
133 |
159 |
173 |
160 |
170 |
97 |
1004 |
| Men, survey-defined hypertension |
88 |
105 |
132 |
146 |
130 |
143 |
84 |
828 |
| Women, self-reported doctor-diagnosed hypertension |
103 |
180 |
212 |
233 |
233 |
164 |
143 |
1268 |
| Women, survey-defined hypertension |
85 |
135 |
176 |
195 |
198 |
138 |
110 |
1037 |
| All adults, self-reported doctor-diagnosed hypertension |
215 |
313 |
371 |
406 |
393 |
334 |
240 |
2272 |
| All adults, survey-defined hypertension |
173 |
240 |
308 |
341 |
328 |
281 |
194 |
1865 |
a Excluding hypertension only in pregnancy
b Bases for self-reported doctor-diagnosed hypertension: Age 16 and over who took part in bio module
c Bases for survey-defined hypertension: Age 16 and over with valid BP measurements
Table 8.9 Detection and treatment of hypertension, 2012/2013 combined, by age and sex
| Aged 16 and over |
|
2012/2013 combined | ||||
| Detection and treatment levels |
Age |
Total |
||||
| 16-34 |
35-54 |
55-64 |
65-74 |
75+ |
||
| % |
% |
% |
% |
% |
% |
|
| Men |
||||||
| Hypertension detection ratea |
* |
48 |
55 |
55 |
[64] |
50 |
| Hypertension treated, but not controlledb |
* |
15 |
23 |
26 |
26 |
20 |
| Hypertension treated and controlledc |
* |
11 |
19 |
18 |
26 |
16 |
| Women |
||||||
| Hypertension detection ratea |
* |
59 |
68 |
66 |
72 |
65 |
| Hypertension treated, but not controlledb |
* |
23 |
24 |
37 |
33 |
29 |
| Hypertension treated and controlledc |
* |
21 |
28 |
25 |
25 |
25 |
| All adults |
||||||
| Hypertension detection ratea |
* |
53 |
61 |
62 |
69 |
58 |
| Hypertension treated, but not controlledb |
* |
19 |
23 |
32 |
30 |
25 |
| Hypertension treated and controlledc |
* |
15 |
24 |
22 |
26 |
20 |
| Bases (weighted): |
||||||
| Men |
23 |
67 |
70 |
58 |
37 |
255 |
| Women |
5 |
60 |
66 |
76 |
70 |
277 |
| All adults |
29 |
128 |
135 |
134 |
107 |
532 |
| Bases (unweighted): |
||||||
| Men |
15 |
62 |
71 |
77 |
43 |
268 |
| Women |
4 |
62 |
86 |
89 |
81 |
322 |
| All adults |
19 |
124 |
157 |
166 |
124 |
590 |
a Detection rate is the proportion of those with survey defined high blood pressure, or who are on medication for high blood pressure, who say they have been told by a doctor they have high blood pressure
b Of those with survey-defined high blood pressure, or who are on medication for high blood pressure, the proportion who are on medication for high blood pressure and also have survey-defined high blood pressure
c Of those with survey-defined high blood pressure, or who are on medication for high blood pressure, the proportion who are on medication for high blood pressure and do not have survey-defined high blood pressure
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Email: Julie Landsberg
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