Notes on the data: Health risk factors

Estimated population, aged 18 years and over with high blood pressure, 2017-18

Policy context: Hypertension or high blood pressure is persistently high pressure in the arteries that can, over time, cause damage to organs such as the kidneys, brain, eyes, and heart. Factors that increase the risk of developing hypertension include obesity, being sedentary, smoking, excessive intake of alcohol and of salt, and the use of some pharmaceuticals (e.g., oral contraceptives, steroids) and drugs (e.g., cocaine, amphetamines). In many cases, the cause of hypertension is not known. In others, it is due to an identifiable condition such as pregnancy, diabetes, thyroid and kidney disease, and a number of rare tumours and hormone abnormalities.

Respondents to the 2017-18 National Health Survey aged 18 years and over who consented had their blood pressure measured. The number of people with high blood pressure presented in this section is based on these measurements, and does not include people who have high blood pressure but are managing their condition through the use of blood pressure medications.

In 2017-18, 22.8% of all Australians aged 18 years and over (4.3 million people) had measured high blood pressure. This was higher than in 2011-12, when 21.5% of adults had measured high blood pressure. It is also over two-thirds above the level of people who reported having hypertension.[1]

Overall, men were more likely to have high blood pressure than women (25.4% and 20.3% respectively), while the proportion of Australians with high blood pressure increased with age with 45.2% of all people aged 75 years and over having measured high blood pressure in 2017-18 [1].

Reference

Australian Bureau of Statistics (ABS). High blood pressure. National Health Survey: First Results, 2017–18 — Australia. Canberra: ABS; 2018. Available from: https://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012017-18?OpenDocument; last accessed 14 October 2019

Notes:

Differences from data published by the Australian Bureau of Statistics (ABS):

Data by quintile of socioeconomic disadvantage and Remoteness will differ to the extent that data extracted from Survey TableBuilder have been randomised, whereas those published by the ABS are not. In addition, rates published by the ABS for modelled estimates are generally crude rates; rates published by PHIDU are age-standardised.

Modelled Estimates:

In the absence of data from administrative data sets, estimates are provided at the Population Health Area (PHA) level for selected health risk factors from the 2017–18 National Health Survey (NHS), conducted by the Australian Bureau of Statistics (ABS). The estimates at the Population Health Area (PHA) are modelled estimates produced by the ABS (estimates at the Local Government Area (LGA) and Primary Health Network (PHN) level were derived from the PHA estimates).

Details of the method used and accuracy of results are available from the ABS paper Explanatory Notes: Modelled estimates for small areas based on the 2017-18 National Health Survey, available here.

For the Primary Health Network (PHN) data, differences between the PHN totals and the sum of LGAs within PHNs result from the use of different geographic correspondence files.

Estimates for quintile of socioeconomic disadvantage of area and Remoteness Area are direct estimates, extracted using the ABS Survey TableBuilder.

Users of these modelled estimates should note that they do not represent data collected in administrative or other data sets. As such, they should be used with caution, and treated as indicative of the likely social dimensions present in an area with these demographic and socioeconomic characteristics.

The numbers are estimates for an area, not measured events as are, for example, death statistics. As such, they should be viewed as a tool that, when used in conjunction with local area knowledge and taking into consideration the prediction reliability, can provide useful information that can assist with decision making for small geographic regions. Of particular note is that the true value of the published estimates is also likely to vary within a range of values as shown by the upper and lower limits published in the data (xlsx) and viewable in the column chart in the single map atlases.

What the modelled estimates do achieve, however, is to summarise the various demographic, socioeconomic and administrative information available for an area in a way that indicates the expected level of each health indicator for an area with those characteristics. In the absence of accurate, localised information about the health indicator, such predictions can usefully contribute to policy and program development, service planning and other decision-making processes that require an indication of the geographic distribution of the health indicator.

The relatively high survey response rate in the NHS provides a high level of coverage across the population; however, the response rate among some groups is lower than among other groups, e.g., those living in the most disadvantaged areas have a lower response rate than those living in less disadvantaged areas. Although the sample includes the majority of people living in households in private dwellings, it excludes those living in the very remote areas of Australia and discrete Aboriginal and Torres Strait Islander communities; whereas these areas comprise less than 3% of the total population, Aboriginal people comprise up to one third of the population. The survey does not include persons usually resident in non-private dwellings (hospitals, gaols, nursing homes - and also excludes members of the armed forces).

This and other limitations of the method mean that estimates have not been published for PHAs with populations under 1,000.

The ABS used a number of methods to measure the quality of the estimates, one of which is the relative root mean squared error (RRMSE) of the modelled estimates. The RRMSEs are included with the data. Users are advised that:

estimates with RRMSEs less than 25% are considered reliable for most purposes;
estimates with RRMSEs from 0.25 and to 0.50 have been marked (~) to indicate that they should be used with caution; and
those greater than 0.50 but less than 1 are marked (~~) to indicate that the estimate is considered too unreliable for general use.

Indicator detail

Information was collected in the National Health Survey using two methods. These were:

a question on whether respondents had ever been told by a doctor or nurse they had any circulatory conditions (including hypertension or high blood pressure), and
for adults aged 18 years and over, the taking of blood pressure measurements.

A person was defined as having high blood pressure if their systolic/diastolic blood pressure was equal to or greater than 140/90 mmHg [1].

These results are based on the latter definition and relate to the 68.4% of respondents aged 18 years and over who had have their blood pressure measured. For those who did not have their blood pressure measured, blood pressure was imputed. For more information see Appendix 2: Physical measurements in the 2017-18 National Health Survey.

Heart Foundation, 2015, Blood pressure. Available from: http://heartfoundation.org.au/your-heart/know-your-risks/blood-pressure; last accessed 04/12/2016

Geography: Data available by Population Health Area, Local Government Area, Primary Health Network, Quintile of socioeconomic disadvantage of area and Remoteness Area

Numerator: Estimated population with measured blood pressure

Denominator: Total population aged 18 years or over

Detail of analysis: Indirectly age-standardised rate per 100 population; and/or indirectly age-standardised ratio, based on the Australian standard

Source:

PHA, LGA & PHN: Age-standardised rates are based on Australian Bureau of Statistics data, produced as a consultancy for PHIDU, from the 2017—18 National Health Survey.

Quintiles & Remoteness: Compiled by PHIDU based on direct estimates from the 2017–18 National Health Survey, ABS Survey TableBuilder.