Journal of General Internal Medicine

, Volume 30, Issue 5, pp 556–564

Documented Lifestyle Education Among Young Adults with Incident Hypertension

  • Heather M. Johnson
  • Andrea G. Olson
  • Jamie N. LaMantia
  • Amy J. H. Kind
  • Nancy Pandhi
  • Eneida A. Mendonça
  • Mark Craven
  • Maureen A. Smith
Original Research

DOI: 10.1007/s11606-014-3059-7

Cite this article as:
Johnson, H.M., Olson, A.G., LaMantia, J.N. et al. J GEN INTERN MED (2015) 30: 556. doi:10.1007/s11606-014-3059-7

ABSTRACT

BACKGROUND

Only 38 % of young adults with hypertension have controlled blood pressure. Lifestyle education is a critical initial step for hypertension control. Previous studies have not assessed the type and frequency of lifestyle education in young adults with incident hypertension.

OBJECTIVE

The purpose of this study was to determine patient, provider, and visit predictors of documented lifestyle education among young adults with incident hypertension.

DESIGN

We conducted a retrospective analysis of manually abstracted electronic health record data.

PARTICIPANTS

A random selection of adults 18–39 years old (n = 500), managed by a large academic practice from 2008 to 2011 and who met JNC 7 clinical criteria for incident hypertension, participated in the study.

MAIN MEASURES

The primary outcome was the presence of any documented lifestyle education during one year after meeting criteria for incident hypertension. Abstracted topics included documented patient education for exercise, tobacco cessation, alcohol use, stress management/stress reduction, Dietary Approaches to Stop Hypertension (DASH) diet, and weight loss. Clinic visits were categorized based upon a modified established taxonomy to characterize patients’ patterns of outpatient service. We excluded patients with previous hypertension diagnoses, previous antihypertensive medications, or pregnancy. Logistic regression was used to identify predictors of documented education.

KEY RESULTS

Overall, 55 % (n = 275) of patients had documented lifestyle education within one year of incident hypertension. Exercise was the most frequent topic (64 %). Young adult males had significantly decreased odds of receiving documented education. Patients with a previous diagnosis of hyperlipidemia or a family history of hypertension or coronary artery disease had increased odds of documented education. Among visit types, chronic disease visits predicted documented lifestyle education, but not acute or other/preventive visits.

CONCLUSIONS

Among young adults with incident hypertension, only 55 % had documented lifestyle education within one year. Knowledge of patient, provider, and visit predictors of education can help better target the development of interventions to improve young adult health education and hypertension control.

KEY WORDS

hypertension patient education primary care electronic health records health behavior 

Copyright information

© Society of General Internal Medicine 2014

Authors and Affiliations

  • Heather M. Johnson
    • 1
    • 2
    • 9
  • Andrea G. Olson
    • 1
  • Jamie N. LaMantia
    • 1
    • 2
  • Amy J. H. Kind
    • 1
    • 2
    • 3
  • Nancy Pandhi
    • 2
    • 4
  • Eneida A. Mendonça
    • 5
    • 6
  • Mark Craven
    • 5
  • Maureen A. Smith
    • 2
    • 4
    • 7
    • 8
  1. 1.Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  2. 2.Health Innovation ProgramUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  3. 3.William S. Middleton Memorial Veterans Hospital Geriatric Research Education and Clinical CenterMadisonUSA
  4. 4.Department of Family MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  5. 5.Department of Biostatistics and Medical InformaticsUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  6. 6.Department of PediatricsUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  7. 7.Department of Population Health SciencesUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  8. 8.Department of SurgeryUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  9. 9.Division of Cardiovascular MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA