Hypertension Awareness and Control Among Young Adults in the National Longitudinal Study of Adolescent Health

Abstract

BACKGROUND: Young adults are less likely than older adults to be aware they have hypertension or to be treated for hypertension. OBJECTIVE: To describe rates of hypertension awareness and control in a cohort of young adults and understand the impact of health insurance, utilization of preventive care, and self-perception of health on rates of hypertension awareness and control in this age group. DESIGN AND PARTICIPANTS: Cross-sectional study of 13,512 young adults participating in Wave IV of the National Longitudinal Study of Adolescent Health in 2007-2008. MAIN MEASURES: We defined hypertension as an average of two measured systolic blood pressures (SBP) ≥ 140 mmHg, diastolic blood pressures (DBP) ≥ 90 mmHg, or self-report of hypertension. We defined hypertension awareness as reporting having been told by a health care provider that one had high blood pressure, and assessed awareness among those with uncontrolled hypertension. We considered those aware of having hypertension controlled if their average measured SBP was < 140 mmHg and DBP was < 90 mmHg. KEY RESULTS: Of the 3,303 young adults with hypertension, 2,531 (76 %) were uncontrolled, and 1,893 (75 %) of those with uncontrolled hypertension were unaware they had hypertension. After adjustment for age, sex, race/ethnicity, weight status, income, education, alcohol and tobacco use, young adults with uncontrolled hypertension who had (vs. didn't have) routine preventive care in the past 2 years were 2.4 times more likely (95 % confidence interval [CI] 1.68-3.55) to be aware, but young adults who believed they were in excellent (vs. less than excellent) health were 64 % less likely to be aware they had hypertension (OR 0.36,. Neither preventive care utilization nor self-rated health was associated with blood pressure control. CONCLUSIONS:In this nationally representative group of young adults, rates of hypertension awareness and control were low. Efforts to increase detection of hypertension must address young adults' access to preventive care and perception of their need for care.KEY WORDS: hypertension; young adult; health services accessibility; health status.

Trends in the Prevalence, Awareness, Treatment, and Control of Hypertension Among Young Adults in the United States, 1999 to 2014

“…These results were consistent with previous NHANES reports, 33, 34 as well as with results from a cross-sectional study of young adults aged 24 to 32 years from the National Longitudinal Study of Adolescent Health, which found that hypertension awareness was about two fold higher in young adults who had seen a provider for routine health care in the past two years. 35 Taken together, these findings suggest that efforts to improve blood pressure control among young adults, particularly men, should focus on raising awareness, improving screening strategy, and advancing follow-up and subsequent linkage to care. 4, 35 With implementation of the Affordable Care Act, the rate of insurance in U.S. adults aged 19–25 years old increased by over 10% since 2010, representing an increase of about 5.7 million young adults with access to a regular source of medical care, and potentially, prevention programs.…”

Awareness of the role of cardiovascular risk factors and their prevention from the perspective of Tricity adolescents

“…The prevalence of systemic arterial hypertension (AH) continues to rise, especially in young adults [2]: in the United States it has reached 19% in 2008 in the 24-32 age group, according to the Add Health study [3]. The problem of the increased blood pressure becomes also conside rable among adolescents.…”

Effects of Repeated Binge Drinking on Blood Pressure Levels and Other Cardiovascular Health Metrics in Young Adults: National Health and Nutrition Examination Survey, 2011‐2014

“…Our findings have important public health relevance for young adults because recent evidence suggests that development of elevated BP before the age of 45 years is associated with significantly higher risks of cardiovascular death later in life compared with those who develop hypertension later in life 37. Rates of hypertension in young adults are increasing, and rates of hypertension awareness and control are lowest in this group 38. As highlighted in several other recent publications, targeting elevated BP and implementing lifestyle interventions to reduce BP in early adulthood may be an important strategy to prevent cardiovascular disease later in life 13, 39.…”