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

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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, 95 % CI 0.23–0.57). 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.

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Acknowledgements

We thank Yuanjun Hu for thoughtful comments on the manuscript. Holly Gooding is supported in part by the Boston Children’s Hospital Office of Faculty Development Career Development Fellowship. This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website (http://www.cpc.unc.edu/addhealth). No direct support was received from grant P01-HD31921 for this analysis.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Authors and Affiliations

  1. Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA

    Holly C. Gooding MD, MS, Tracy K. Richmond MD, MPH & Alison E. Field ScD

  2. Department Pediatrics, Harvard Medical School, Boston, USA

    Holly C. Gooding MD, MS, Tracy K. Richmond MD, MPH & Alison E. Field ScD

  3. Department of Medicine, Beth Israel Deaconess Hospital, Boston, USA

    Shannon McGinty MD

  4. Obesity Prevention Program, Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, USA

    Matthew W. Gillman MD, SM

  5. Department of Nutrition, Harvard School of Public Health, Boston, USA

    Matthew W. Gillman MD, SM

  6. Department of Epidemiology, Harvard School of Public Health, Boston, USA

    Alison E. Field ScD

  7. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, USA

    Alison E. Field ScD

Authors
  1. Holly C. Gooding MD, MS
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  2. Shannon McGinty MD
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  3. Tracy K. Richmond MD, MPH
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  4. Matthew W. Gillman MD, SM
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  5. Alison E. Field ScD
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Corresponding author

Correspondence to Holly C. Gooding MD, MS.

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Gooding, H.C., McGinty, S., Richmond, T.K. et al. Hypertension Awareness and Control Among Young Adults in the National Longitudinal Study of Adolescent Health. J GEN INTERN MED 29, 1098–1104 (2014). https://doi.org/10.1007/s11606-014-2809-x

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  • DOI: https://doi.org/10.1007/s11606-014-2809-x

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