Hypertension Awareness and Control Among Young Adults in the National Longitudinal Study of Adolescent Health
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Young adults are less likely than older adults to be aware they have hypertension or to be treated for hypertension.
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.
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.
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, 95 % CI 0.23–0.57). Neither preventive care utilization nor self-rated health was associated with blood pressure control.
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.
- Hypertension Awareness and Control Among Young Adults in the National Longitudinal Study of Adolescent Health
Journal of General Internal Medicine
Volume 29, Issue 8 , pp 1098-1104
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- Springer US
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- young adult
- health services accessibility
- health status
- Industry Sectors
- Author Affiliations
- 1. Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
- 2. Department Pediatrics, Harvard Medical School, Boston, USA
- 3. Department of Medicine, Beth Israel Deaconess Hospital, Boston, USA
- 4. Obesity Prevention Program, Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, USA
- 5. Department of Nutrition, Harvard School of Public Health, Boston, USA
- 6. Department of Epidemiology, Harvard School of Public Health, Boston, USA
- 7. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, USA