Khader Esra'a I, Polgreen Linnea A
Department of Pharmacy Practice and Science, University of Iowa, Iowa City, Iowa, USA.
J Clin Hypertens (Greenwich). 2025 Aug;27(8):e70119. doi: 10.1111/jch.70119.
Hypertension (HTN) is common among young adults, but often undiagnosed. Early diagnosis and management are crucial to prevent cardiovascular events. However, young adults are less aware of their HTN and are diagnosed less frequently. This study aims to identify adults aged 18-40 in Iowa with high blood pressure (HBP) and determine the percentage diagnosed with HTN and associated risk factors. This retrospective observational study analyzed electronic health records from the University of Iowa Healthcare outpatient, inpatient, and emergency departments between 2016 and 2022. We included adults aged 18-40 with at least three elevated BP readings (systolic ≥140 or diastolic ≥90). Patients were followed for 2 years to identify those diagnosed with HTN. Summary statistics were calculated, and a Cox regression model assessed the time to HTN diagnosis. We identified 22,299 adults with at least three HBP readings. Among 7,523 young adults with at least three elevated BP readings, only 17.4% received a HTN diagnosis within 2 years. Most diagnoses occurred in outpatient (57.2%), followed by emergency (24%) and inpatient (17.5%) settings. Young adults had a significantly longer time to diagnosis than older populations. Young males, African Americans, Hispanics, patients with diabetes or dyslipidemia, and patients with more healthcare visits had shorter times to diagnosis. In conclusion, 7,523 out of 22,299 (33.7%) patients with HBP were young adults, with only 17.4% diagnosed with HTN within 2 years. The low diagnosis rate is concerning, given the potential for long-term cardiovascular complications. Improved screening protocols and targeted interventions are needed to address age-related underdiagnosis.
高血压（HTN）在年轻人中很常见，但往往未被诊断出来。早期诊断和管理对于预防心血管事件至关重要。然而，年轻人对自己的高血压了解较少，被诊断出来的频率也较低。本研究旨在识别爱荷华州18至40岁的高血压（HBP）患者，并确定被诊断为高血压的百分比以及相关危险因素。这项回顾性观察研究分析了2016年至2022年期间爱荷华大学医疗保健门诊、住院和急诊科的电子健康记录。我们纳入了18至40岁且至少有三次血压读数升高（收缩压≥140或舒张压≥90）的成年人。对患者进行了2年的随访，以确定那些被诊断为高血压的患者。计算了汇总统计数据，并使用Cox回归模型评估了高血压诊断时间。我们识别出22299名至少有三次高血压读数的成年人。在7523名至少有三次血压读数升高的年轻人中，只有17.4%在2年内被诊断为高血压。大多数诊断发生在门诊（57.2%），其次是急诊（24%）和住院（17.5%）环境。年轻人的诊断时间明显比老年人群长。年轻男性、非裔美国人、西班牙裔、患有糖尿病或血脂异常的患者以及就诊次数较多的患者诊断时间较短。总之，22299名高血压患者中有7523名（33.7%）是年轻人，其中只有17.4%在2年内被诊断为高血压。考虑到长期心血管并发症的可能性，低诊断率令人担忧。需要改进筛查方案和有针对性的干预措施来解决与年龄相关的诊断不足问题。
