Biostatistics Journal Club: Use of censored data methods to develop an algorithm for determining blood pressure norms in u.s. adults

Age-sex-height specific blood pressure (BP) percentiles are commonly used for risk stratification and clinical management in children and adolescents age 1-17. However, for adults, risk stratification is determined based on absolute levels of BP. Traditionally, a cut-point of  SBP/DBP =140/90 mm Hg has been used to define hypertension in adults, which has been recently modified to 130/80 mm Hg. The same criteria are used regardless of age and gender. Another possible approach is to use age-sex-specific BP percentiles in adults. However, a major problem is that approximately 15% of adults are on anti-hypertensive medication (MEDS) which will skew results towards lower values.

In this talk, Bernie Rosner, PhD, Brigham and Women’s Hospital, will discuss the use of censored data methods to account for the use of MEDS and estimate underlying (or untreated) BP at an individual level among subjects on MEDS. These analyses are based on data from 37,345 subjects without prior heart disease or diabetes in NHANES surveys from 1999-2018, among whom 5580 were currently on MEDS.

Speaker:

Bernie Rosner, PhD, Brigham and Women’s Hospital 

Required Reading:

Adjusting for Treatment Effects in Studies of Quantitative Traits: Antihypertensive Therapy and Systolic Blood Pressure