Journal
JOURNAL OF HYPERTENSION
Volume 36, Issue 12, Pages 2425-2433Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HJH.0000000000001872
Keywords
ambulatory care; Cox proportional hazards models; healthcare disparities; hypertension; Kaplan-Meier analysis; young adult
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Funding
- National Center for Advancing Translational Sciences of the National Institutes of Health (NIH) [UL1TR000427]
- National Heart, Lung, and Blood Institute of the NIH [K23HL112907]
- National Institute of Arthritis and Musculoskeletal and Skin Diseases of the NIH [K23AR062381]
- UW Health Innovation Program
- UW School of Medicine and Public Health from the Wisconsin Partnership Program
- NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES [UL1TR000427, UL1TR002373] Funding Source: NIH RePORTER
- NATIONAL CENTER FOR RESEARCH RESOURCES [UL1RR025011] Funding Source: NIH RePORTER
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [K23HL112907] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES [K23AR062381] Funding Source: NIH RePORTER
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Objective: Despite a growing prevalence of hypertension, young adults (18-39-year-olds) have lower hypertension control rates compared with older adults. The purpose of this study was to evaluate the role of sociodemographic factors in hypertension control among young adults with regular primary care access. Methods: A retrospective analysis included 3208 patients, 18-39 years old, who met clinical criteria for an initial (incident) hypertension diagnosis in a large, Midwestern, academic practice from 2008 to 2011. Patients with a prior antihypertensive medication prescription were excluded. Kaplan-Meier analysis was used to estimate the probability of achieving hypertension control over 24 months by sex. Cox proportional hazard models were fit to identify sociodemographic predictors of delays in hypertension control. Results: Among the 3208 young adults with incident hypertension, 48% achieved hypertension control within 24 months. Kaplan-Meier analysis demonstrated that young women had a higher hypertension control rate at 24 months (57%) compared with young men (41%). According to adjusted hazard models, young men had a 39% lower rate of hypertension control (hazard ratio 0.61; 95% confidence interval 0.55-0.69) compared with women. Being unmarried (0.87; 0.78-0.98) and a non-English primary language speaker (0.47; 0.37-0.60) also predicted lower hypertension control rates. Conclusion: Sex disparities, being unmarried, and non-English primary language are important barriers to hypertension control among young adults with regular primary care use. Interventions tailored to sociodemographic characteristics may improve hypertension control in this challenging population.
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