7. Deriving indicators from the data

The formulae for deriving the indicators listed in Part I from the data described in the protocols and questionnaires in Part III are given in this section. The formulae given here apply directly for a sex/10-year age group if simple random sampling was used. Age standardization, when a wider age group is considered, or possible other weighting, such as adjusting for a more complex sampling scheme, are not considered here.

7.2 Blood pressure

7.2.1 Definition of variables

Definition of variables in data:

HR	Heart rate (twice 30 second pulse count)
SBP1/DBP1	systolic/diastolic blood pressure from 1st measurement 999 if insufficient data
SBP2/DBP2	systolic/diastolic blood pressure from 2nd measurement 999 if insufficient data
SBP3/DBP3	systolic/diastolic blood pressure from 3rd measurement 999 if insufficient data
HBP1	When was your blood pressure last measured by a health professional? 1 = within the past 12 months 2 = 1-5 years ago 3 = not within the past 5 years 9 = insufficient data
HBP2	Have you been told my a health professional in the past year (12 months) that you have elevated blood pressure or hypertension? 1 = yes 2 = no 3 = uncertain 9 = insufficient data
HBP3	Are you currently taking medications prescribed by a doctor to lower your blood pressure? 1 = yes 2 = no 3 = uncertain 9 = insufficient data
HBP4	Has a doctor in the past year ordered you to change your way of life, in order to lower your blood pressure? 1 = yes 2 = no 3 = uncertain 9 = insufficent data

Additional derived variables used in calculations of indicators:

MSBP	Mean of two systolic blood pressure readings MSBP = (SBP2 + SBP3)/2, if SBP2 < 999 and SBP3 < 999 MSBP = 999, if SBP2 = 999 or SBP3 = 999
MDBP	Mean of two diastolic blood pressure reading MDBP = (DBP2 + DBP3)/2, if DBP2 < 999 and DBP3 < 999 MDBP = 999, if DBP2 = 999 or DBP3 = 999

7.2.2 Deriving indicators

Primary indicators

Prevalence of actual and potential hypertension:

Numerator:	respondents with MSBP > 140 or MDBP > 90 or HBP3 = 1
Denominator:	all respondents with MSBP < 999 and MDBP < 999 and HBP3 either 1, 2 or 3

Prevalence of antihypertensive drug treatment among actual and potential hypertensives:

Numerator:	respondents with HBP3 = 1
Denominator:	all respondents with MSBP > 140 or MDBP > 90 or HBP3 = 1

Prevalence of antihypertensive drug treatment in the population:

Numerator:	respondents with HBP3 = 1
Denominator:	all respondents with HBP3 ¹ 9

Awareness of elevated blood pressure:

Numerator:	respondents with HBP2 = 1
Denominator:	respondents with MSBP > 140 or MDBP > 90 or HBP3 = 1

Proportion of population with blood pressure measurement in the past 5 years:

Numerator:	respondents with HBP1 either 1 or 2
Denominator:	all respondents with HBP1 ¹ 9

Secondary indicators

Prevalence of elevated systolic blood pressure:

Numerator:	respondents with MSBP > 140
Denominator:	all respondents with MSBP < 999

Effectiveness of antihypertensive drug treatment:

Numerator:	respondents with HBP3 = 1 and MSBP < 140 and MDBP < 90
Denominator:	all respondents with HBP3 = 1

Prevalence of non-pharmacological treatment of hypertension among actual and potential hypertensives:

Numerator:	respondents with HBP4 = 1
Denominator:	all respondents with HBP4 1 ¹ 9 and (MSBP > 140 or MDBP > 90 or HBP1 = 1)

Proportion of population with blood pressure measurement in the past year:

Numerator:	respondents with HBP1 = 1
Denominator:	all respondents with HBP1 ¹ 9

7.3 Lipids

7.3.1 Definition of variables

Definition of variables in data:

CHOL	cholesterol concentration 999 = insufficient data
HDL	HDL concentration 999 = insufficient data
LDL	LDL concentration 999 = insufficient data
TRIG	triglycerides concentration 999 = insufficient data
HCL1	When was your blood cholesterol last measured? 1 = within the past 12 months 2 = 1-5 years ago 3 = not within the past 5 years 9 = insufficient data
HCL2	Have you been told by a health professional in the past year (12 months) that you have raised (elevated) blood cholesterol? 1 = yes 2 = no 3 = uncertain 9 = insufficient data
HCL3	Are you currently taking medication prescribed by a doctor to lower your blood cholesterol level? 1 = yes 2 = no 3 = uncertain 9 = insufficient data
HCL4	Has a doctor in the past year ordered you to change your way of life, in order to lower your total blood cholesterol? 1 = yes 2 = no 3 = uncertain 9 = insufficient data

Additional derived variables used in calculations of indicators:

TC_HDL

TC_HDL = CHOL/HDL, if CHOL < 999 and HDL < 999
TC_HDL = 999, if CHOL = 999 or HDL = 999

7.3.2 Deriving indicators

Primary indicators

Prevalence of elevated serum total cholesterol:

Numerator:	respondents with CHOL > 5.0
Denominator:	all respondents with CHOL < 999

Prevalence of lipid lowering drug treatment in the population:

Numerator:	respondents with HCL3 = 1
Denominator:	all respondents with HCL3 ¹ 9

Awareness of elevated serum cholesterol or hypercholeseterolemia:

Numerator:	respondents with HCL2 = 1
Denominator:	all respondents with HCL2 ¹ 9 and CHOL > 5.0

Proportion of population with cholesterol measurement in the past 5 years:

Numerator:	respondents with HCL1 either 1 or 2
Denominator:	all respondents with HCL1 ¹ 9

Secondary indicators

Prevalence of elevated serum total cholesterol using different cut-points (for example if cut-point is 6.0 mmol/l):

Numerator:	respondents with CHOL > 6.0
Denominator:	all respondents with CHOL < 999

Prevalence of low HDL cholesterol:

Numerator:	respondents with HDL < 1.0
Denominator:	all respondents with HDL < 999

Prevalence of elevated serum triglycerides:

Numerator:	respondents with TRIG > 2.0
Denominator:	all respondents with TRIG < 999

Prevalence of elevated LDL cholesterol:

Numerator:	respondents with LDL > 3.0
Denominator:	all respondents with LDL < 999

Prevalence of high total cholesterol to HDL ratio:

Numerator:	respondents with TC_HDL > 5
Denominator:	all respondents with TC_HDL < 999

Proportion of the population with cholesterol measurement in the past year:

Numerator:	respondents with HCL1 = 1
Denominator:	all respondents with HCL1 ¹ 9

Prevalence of non-pharmacological treatment of hypercholesterolemia:

Numerator:	respondents with HCL4 = 1
Denominator:	all respondents with HCL4 ¹ 9 and CHOL > 5.0

7.4 Obesity

7.4.1 Definition of variables

Definition of variables in data:

WEIGHT	measured weight (kg) 999 if insufficient data
HEIGHT	measured height (cm) 999 if insufficient data
WAIST	measured waist circumference (cm) 999 if insufficient data
HIP	measured hip circumference (cm) 999 if insufficient data

Additional derived variables used in calculations of indicators:

BMI	BMI = WEIGHT/(HEIGHT*HEIGHT), if WEIGHT < 999 and HEIGHT < 999 BMI = 999, if WEIGHT = 999 or HEIGHT = 999
WHR	WHR = WAIST/HIP, if WAIST < 999 and HIP < 999 WHR = 999, if WAIST = 999 or HIP = 999

7.4.2 Deriving indicators

Primary indicators

Prevalence of obesity:

Numerator:	respondents with BMI > 30
Denominator:	all respondents with BMI < 999

Secondary indicators

Prevalence of categories of BMI (for example if category is grade 1 overweight: 25-30):

Numerator:	respondents with 25< BMI < 30
Denominator:	all respondents with BMI < 999

Prevalence of waist/hip ratio > 0.95 for men and > 0.80 for women:

Numerator:	male respondents with WHR > 0.95 and female respondents with WHR > 0.80
Denominator:	all respondents with WHR < 999

7.5 Smoking

7.5.1 Definition of variables

Definition of variables in data:

SMK1	Have you smoked at least 100 cigarettes, cigars or pipefuls in your lifetime? 1 = yes 2 = no 3 = uncertain 9 = insufficient data
SMK2	Have you ever smoked daily (=almost every day for at least one year)? 1 = yes 2 = no 3 = uncertain 9 = insufficient data
SMK3	Do you now smoke? 1 = yes, daily 2 = yes, occasionally 3 = not at all 9 = insufficient data
SMK4	When did you stop smoking daily? 1 = today or yesterday 2 = 2 days - 6 days ago 3 = 1 week - less than 1 month ago 4 = 1 month - less than 1 year ago 5 = 1- 5 years ago 6 = more than 5 years ago 9 = insufficient data
SMK5	On average, how many times do you smoke per day (= number of cigarettes, cigars, or pipufulls of tobacco etc.)? 999 = insufficient data
SMK6a SMK6b SMK6c SMK6d	Which of the products do you frequently smoke? Manufactured cigarettes (1 = yes, 2 = no, 9 = insufficient data) Self-rolled cigarettes (1 = yes, 2 = no, 9 = insufficient data) Pipe (1 = yes, 2 = no, 9 = insufficient data) Cigars (1 = yes, 2 = no, 9 = insufficient data)
SMK7	Have you during the past year (12 months) been advised by a health professional to stop smoking? 1 = yes 2 = no 3 = I have not smoked during the past 12 months 9 = insufficient data
SMK8	Are you exposed to indoor tobacco smoke at home? 1 = yes 2 = no 9 = insufficient data
SMK9	About how many hours per day are you exposed to indoor tobacco smoke at your workplace? 1 = I do not work outside the home 2 = almost never 3 = less than one hour a day 4 = 1-5 hours a day 5 = more than 5 hours a day 9 = insufficient data

7.5.2 Deriving indicators

Primary indicators

Prevalence of daily smokers:

Numerator:	respondents with SMK3 = 1
Denominator:	all respondents with SMK1 ¹ 9

Prevalence of never daily smokers:

Numerator:	respondents with (SMK1 either 2 or 3) or SMK2 = 2 or 3
Denominator:	all respondents with SMK1 ¹ 9

Prevalence of ex-daily smokers:

Numerator:	respondents with SMK2 = 1 and SMK3 either 2 or 3
Denominator:	all respondents with SMK1 ¹ 9

Prevalence of daily cigarette smokers:

Numerator:	respondents with SMK3 = 1 and (SMK6a = 1 or SMK6b = 1)
Denominator:	all respondents with SMK1 ¹ 9 and (SMK6a and SMK6b ¹ 9)

Secondary indicators

Prevalence of occasional smokers:

Numerator:	respondents with SMK3 = 2
Denominator:	all respondents with SMK1 ¹ 9

Mean number of times smoked per day in population:

Numerator:	sum of SMK5 over all respondents with SMK5 ¹ 999
Denominator:	number of respondents with SMK5 ¹ 999

Mean number of times smoked per day by daily smokers:

Numerator:	sum of SMK5 over all respondents with SMK3 = 1 and SMK5 ¹ 999
Denominator:	number of respondents with SMK3 = 1 and SMK5 ¹ 999

Proportion of daily smokers advised by health professional to quit smoking:

Numerator:	respondents with SMK3 = 1 and SMK7 = 1
Denominator:	all respondents with SMK3 = 1 and SMK7 ¹ 9

Prevalence of those who are exposed to indoor tobacco smoke at work site:

Numerator:	respondents with (SMK1 = 2 or 3 or SMK2 = 2 or 3 or SMK3 = 3) and SMK9 either 3, 4 or 5
Denominator:	all respondents with (SMK1 = 2 or 3 or SMK2 = 2 or 3 or SMK3 = 3) and SMK9 ¹ 9

Prevalence of those who are exposed to indoor tobacco smoke at home:

Numerator:	respondents with (SMK1 = 2 or 3 or SMK2 = 2 or 3 or SMK3 = 3) and SMK8 = 1
Denominator:	all respondents with (SMK1 = 2 or 3 or SMK2 = 2 or 3 or SMK3 = 3) and SMK8 ¹ 9

7.6 Antiplatelet drugs

7.6.1 Definition of variables

Definition of variables in data:

ASP	Are you currently taking Aspirin ™ or equivalent acetylsalicylic acid containing medication to prevent or treat heart disease or stroke? 1 = yes 2 = no 3 = uncertain 9 = insufficient data

Additional derived variables used in calculation of indicator:

AGE	age at the date of examination (derived from data of birth and date of examination)

7.6.2 Deriving indicators

Secondary indicators

Prevalence of use of acetylsalicylic acid or similar drugs to prevent or treat heard disease or stroke:

Numerator:	respondents with 55 < AGE < 74 and ASP = 1
Denominator:	all respondent with 55 < AGE < 74 and ASP either 1, 2 or 3

7.7 Hormone replacement therapy

7.7.1 Definition of variables

Definition of variables in data:

WOM1	Have you had any periods during the past six months? 1 = yes 2 = no 3 = uncertain 9 = insufficient data
WOM2	Are you currently using hormone replacement therapy? 1 = yes 2 = no 3 = uncertain 9 = insufficient data

7.7.2 Deriving indicators

Secondary indicators

Prevalence of women using hormone replacement therapy:

Numerator:	female respondents with 45 < AGE < 74 and WOM2 = 1
Denominator:	all female respondent with 45 < AGE < 74 and WOM2 either 1, 2 or 3

7.8 Glucose

7.8.1 Definition of variables

Definition of variables in data:

GLUC	Fasting plasma glucose 999 if insufficient data
DIAB1	Have you ever been told by a doctor that you have diabetes? 1 = yes 2 = no 3 = uncertain 9 = insufficient data
DIAB2	Are you currently taking insulin or pills to control diabetes? 1 = yes 2 = no 3 = uncertain 9 = insufficient data

7.8.2 Deriving indicators

Secondary indicators

Prevalence of impaired fasting glycemia

Numerator:	respondents with 6.1 < GLUC < 7.0
Denominator:	all respondents with GLUC ¹ 999

Prevalence of provisional diagnosis of diabetes:

Numerator:	respondents with GLUC > 7.0
Denominator:	all respondents with GLUC ¹ 999

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