Improving European Health Interview Survey (EHIS) data on high blood pressure and high cholesterol

Abstract Background EU Member States and additional European countries regularly collect comparable health data in the European Health Interview Survey (EHIS) including self-reported high blood pressure (BP) and high cholesterol which are major cardiovascular risk factors. However, EHIS lacks information on current medication and survey participants may report e.g. not having high BP in the past 12 months if their BP is well controlled under medication. Methods We use data of a subsample of the EHIS Survey Wave 4 (2025) in Germany, which is currently being collected, and the 2014/2015 EHIS Survey Wave2, with 22,909 participants aged 18-79 years. We compare prevalences of self-reported high BP and high cholesterol in the past 12 months (EHIS prevalence), to prevalences which additionally classify those who report current intake of medication for high BP or high cholesterol as having the condition (improved-definition prevalence). We further analyze if the relative prevalence differences vary by sex, age and CASMIN-educational groups. Results 12-months-prevalences according to the improved-definition vs. the current single-EHIS-question in Germany in EHIS Wave 2 were: high BP 31.7% (95% confidence intervals 30.8-32.6) vs. 28.8% (28.0-29.6) and high cholesterol 22.4% (21. 7-23.2) vs. 20.0% (19.3-20.8). In relative terms, prevalence by the improved definition was higher by 10% for high BP and 12% for high cholesterol compared to the EHIS prevalence. Results from the current EHIS Wave 4 will be available in late summer. This relative prevalence gap was higher in men, in the lower educational group and with increasing age, e.g. in the oldest age group 70-79 years, it was 16% for high BP and 21% for high cholesterol. Conclusions While the EHIS cannot capture undiagnosed high BP and high cholesterol since it is an interview survey and lacks measurements and laboratory tests, it can improve its estimates by adding two simple questions on current medication intake. Key messages • Current EHIS data underestimate prevalences of high blood pressure and high cholesterol in Europe. • Adding simple questions on current medication intake can improve this.