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20-10-2013 | Cardiology | Article

Interventions needed to boost hypertension diagnosis in young adults

Abstract

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medwireNews: Diagnosis of hypertension is often delayed in young adults, even if they make regular use of primary healthcare, report researchers.

“Previous research suggests that the lack of a regular source of primary care is a significant contributor to gaps in hypertension control among young adults,” say study author Heather Johnson (University of Wisconsin School of Medicine and Public Health, Madison, USA) and colleagues.

But their current findings, using retrospective data from 14,970 adults, shows that diagnosis is delayed in young adults even if they have a regular primary care provider. The team included patients only if they had at least two primary care visits (or one primary and one urgent care visit) within the preceding 3 years.

“These critical findings underscore the need for healthcare system interventions tailored to young adults to improve the diagnosis of hypertension,” the researchers write in the Journal of Hypertension.

The patients were included from the point at which they met criteria for a hypertension diagnosis: three readings at least 30 days apart within a 2-year period of systolic blood pressure of at least 140 mmHg or diastolic blood pressure of at least 90 mmHg, or two readings of at least 160 or 100 mmHg, respectively.

Within 2 years of this date, 39% of patients aged 18–24 years and 43% of those aged 25–31 years received a hypertension diagnosis or were prescribed antihypertensives, compared with 49% of those aged 32–39 years and 54% of those aged 40 years or older. After 4 years, the rate of hypertension diagnosis rose to 56% among patients aged 18–24 years, but reached 71% and 73% in those aged 40–59 years and 60 years or older, respectively.

The time to a diagnosis in those who received one did not differ by age group, at a median of about 1–2 months and an average of 5–6 months.

Being younger than 40 years remained associated with a reduced likelihood for a diagnosis, compared with adults aged 60 years, after accounting for confounders. Other independent predictors included intermittently normal blood pressure at baseline, and current smoking. Predictors of a faster diagnosis included diabetes, stage 2 hypertension, and African–American ethnicity.

Predictors were similar among patients younger than 40 years. “However, none of the variables fully explained the diagnostic inertia related to age,” says the team.

In the overall population, patients with stage 2 hypertension were diagnosed faster in later than earlier study years. “However, this interaction was not significant among young adults, highlighting a continued gap in hypertension management between younger and older adult populations,” say Johnson et al.

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Eleanor McDermid, Senior medwireNews Reporter

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