, et al
Hypertension awareness and control among young adults in the National Longitudinal Study on Adolescent Health
J Gen Intern Med.
; doi:

Investigators from Boston examined the rate of hypertension (HTN) and the relationship of HTN with multiple socioeconomic and demographic variables, control of HTN, and awareness of HTN in a cohort of young adults. Data were collected from participants aged 24 to 32 years from wave IV of the National Longitudinal Study of Adolescent Health (Add Health). The primary outcome variables were (1) participant blood pressure, defined as hypertensive if the average measured systolic blood pressure (SBP) was ≥140 mmHg, the average measured diastolic blood pressure (DBP) was ≥90 mmHg, or if participants were aware they had HTN because they were told as much by a health care provider (HTN awareness), and (2) HTN control, defined as an average measured SBP <140 mmHg and an average measured DBP <90 mmHg in those with a history of HTN. The primary exposure variables included health insurance status (uninsured, public, or private), recent preventive care (within or ≥2 years), and self-rated health (excellent vs less than excellent). Additional covariates collected included sociodemographics, weight, tobacco use, and use of BP medication.

Of the 15,071 Add Health participants, 86% (N=13,512) were included in the study. The prevalence of HTN was 25.5%, with 11% reporting they were told by a health care provider they were hypertensive and 19.4% having a measured BP in the hypertensive range. Among those with HTN, 76.2% had uncontrolled HTN and 74.9% of those with uncontrolled HTN were not aware that they were hypertensive. Only 55.4% of the 1,410 participants who were aware of their HTN had it controlled to goal levels.

The prevalence of HTN was higher in older, male, non-Hispanic black, currently smoking, obese, lower income, and less educated participants. Neither recent preventive health care, health insurance status, nor self-perception of health status was associated with HTN control in models either unadjusted or adjusted for covariates. Adjusted models showed that male (OR = 0.71; 95% CI, 0.53–0.95) and obese (OR = 0.47; 95% CI, 0.31–0.70) participants were less likely to have their HTN controlled. HTN awareness was increased in those with recent preventive care (OR = 2.4; 95% CI, 1.68–3.35) but decreased in those with excellent self-rated health (OR = 0.36; 95% CI, 0.23–0.57).

The investigators conclude that HTN control and awareness are low among young adults.

Dr Wardrop has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

HTN is, and will continue to be, one of the most important risk factors for the development of cardiovascular disease, making the results of this study particularly alarming. The prevalence of HTN in this nationally diverse and representative cohort is much higher than that seen in past studies based...

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