Hypertension prevalence in young adults unexpectedly high

Hypertension may be more common among young adults than previously thought, data from the National Study of Adolescent Health (Add Health) indicate.

Hypertension prevalence among the 15,701 participants aged 24 to 32 years was 19% in 1998, according to Quynh Nguyen, MSPH, a doctoral student at the University of North Carolina's Gillings School of Global Public Health in Chapel Hill, and colleagues.

This is much higher than the 4% prevalence reported among young adults who participated in the National Health and Nutrition Examination Survey (NHANES) during a similar time period.

The cross-survey comparison included data from 14,252 Add Health participants and 733 NHANES participants.

“Our respective findings may differ, but the message is clear,” study researcher Kathleen Mullan Harris, PhD, interim director of the University of North Carolina Population Center, said in a press release. “Young adults and the medical professionals they visit shouldn't assume they're not old enough to have high BP.”

Although hypertension rates, defined as BP ≥ 140/90 mmHg, were higher among Add Health participants than NHANES participants, self-reported history of hypertension was similar between the two groups (11% vs. 9%).

This indicates that the percentage of young adults with elevated BP that participated in Add Health was nearly double the proportion that were previously told by a health care provider that they had hypertension.

Furthermore, in addition to the higher proportion of Add Health participants with elevated BP, mean BP rates were higher in this study group compared with NHANES rates — 125/79 mm Hg versus 114/67 mm Hg. These differences remained consistent across sociodemographic subgroups, data indicated.

Differences in BP collection data, including digit preference, low validity or reliability, participant selection, measurement context and interview content, did not explain the disparity in hypertension rates between the two studies, according to the researchers.

The increased likelihood for hypertension remained even after the researchers adjusted for confounding participant characteristics, including antihypertensive use and food, cigarette and caffeine consumption prior to BP measurement (OR 6.6, 95% CI 4.0 to 11.0).

Hypertension is a well-known risk factor for stroke and coronary heart disease, the leading cause of death in U.S. adults.

“Our results show that the processes that trigger these problems begin early in life, but they are preventable, so it's important to check for hypertension now and head it off at the pass, in order to avoid these health and societal costs later on,” Harris said.

The researchers acknowledged that the validity of BP measurements was not monitored throughout the Add Health survey and that the sample size was too small to determine subgroup differences in the reliability of BP measurements.

Nguyen QC. Epidemiology. 2011;22:532-541.

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