title: Hypertension awareness and control among young adults in the national longitudinal study of adolescent health.
abstract: BACKGROUND
  Young adults are less likely than older adults to be aware they have hypertension or to be treated for hypertension.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  Cross-sectional study of 13,512 young adults participating in Wave IV of the National Longitudinal Study of Adolescent Health in 2007-2008.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA, holly.gooding@childrens.harvard.edu.
authors.forename: Holly C
authors.initials: HC
authors.lastname: Gooding
authors.forename: Shannon
authors.initials: S
authors.lastname: McGinty
authors.forename: Tracy K
authors.initials: TK
authors.lastname: Richmond
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
authors.forename: Alison E
authors.initials: AE
authors.lastname: Field
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001364:Awareness / Q000502:physiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents