Gooding Holly C, McGinty Shannon, Richmond Tracy K, Gillman Matthew W, Field Alison E
Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA,
J Gen Intern Med. 2014 Aug;29(8):1098-104. doi: 10.1007/s11606-014-2809-x. Epub 2014 Feb 28.
Young adults are less likely than older adults to be aware they have hypertension or to be treated for hypertension.
To describe rates of hypertension awareness and control in a cohort of young adults and understand the impact of health insurance, utilization of preventive care, and self-perception of health on rates of hypertension awareness and control in this age group.
Cross-sectional study of 13,512 young adults participating in Wave IV of the National Longitudinal Study of Adolescent Health in 2007-2008.
We defined hypertension as an average of two measured systolic blood pressures (SBP) ≥ 140 mmHg, diastolic blood pressures (DBP) ≥ 90 mmHg, or self-report of hypertension. We defined hypertension awareness as reporting having been told by a health care provider that one had high blood pressure, and assessed awareness among those with uncontrolled hypertension. We considered those aware of having hypertension controlled if their average measured SBP was < 140 mmHg and DBP was < 90 mmHg.
Of the 3,303 young adults with hypertension, 2,531 (76%) were uncontrolled, and 1,893 (75%) of those with uncontrolled hypertension were unaware they had hypertension. After adjustment for age, sex, race/ethnicity, weight status, income, education, alcohol and tobacco use, young adults with uncontrolled hypertension who had (vs. didn't have) routine preventive care in the past 2 years were 2.4 times more likely (95% confidence interval [CI] 1.68-3.55) to be aware, but young adults who believed they were in excellent (vs. less than excellent) health were 64% less likely to be aware they had hypertension (OR 0.36, 95% CI 0.23-0.57). Neither preventive care utilization nor self-rated health was associated with blood pressure control.
In this nationally representative group of young adults, rates of hypertension awareness and control were low. Efforts to increase detection of hypertension must address young adults' access to preventive care and perception of their need for care.
与老年人相比，年轻人不太可能意识到自己患有高血压或接受高血压治疗。
描述一组年轻成年人的高血压知晓率和控制率，并了解医疗保险、预防性保健的利用情况以及健康自我认知对该年龄组高血压知晓率和控制率的影响。
对2007 - 2008年参加青少年健康全国纵向研究第四波的13512名年轻成年人进行横断面研究。
我们将高血压定义为两次测量的收缩压（SBP）平均值≥140 mmHg、舒张压（DBP）平均值≥90 mmHg，或自我报告患有高血压。我们将高血压知晓定义为报告曾被医疗保健提供者告知患有高血压，并评估未控制高血压患者中的知晓情况。如果平均测量的SBP < 140 mmHg且DBP < 90 mmHg，我们认为那些知晓自己患有高血压的人血压得到了控制。
在3303名患有高血压的年轻成年人中，2531人（76%）血压未得到控制，其中1893人（75%）未控制高血压的患者不知道自己患有高血压。在调整年龄、性别、种族/民族、体重状况、收入、教育程度、酒精和烟草使用情况后，过去2年接受（与未接受）常规预防性保健的未控制高血压的年轻成年人知晓自己患有高血压的可能性高2.4倍（95%置信区间[CI] 1.68 - 3.55），但认为自己健康状况极佳（与不太好）的年轻成年人知晓自己患有高血压的可能性低64%（比值比0.36，95% CI 0.23 - 0.57）。预防性保健的利用和自我评估的健康状况均与血压控制无关。
在这个具有全国代表性的年轻成年人群体中，高血压知晓率和控制率较低。提高高血压检测率的努力必须解决年轻人获得预防性保健的机会以及他们对保健需求的认知问题。
