title: Differential Diagnosis and Treatment Rates Between Systolic and Diastolic Hypertension in Young Adults: A Multidisciplinary Observational Study.
abstract: Differential rates of diagnosis and treatment by hypertension (HTN) type may contribute to poor HTN control in young adults. The objective of this study was to compare rates of receiving a hypertension diagnosis and antihypertensive agent among young adults with (1) isolated systolic, (2) isolated diastolic, and (3) combined systolic/diastolic HTN. A retrospective analysis was conducted in patients aged 18 to 39 years (n=3003) with incident HTN. Kaplan-Meier survival and Cox proportional hazards analyses were performed. Only 56% with isolated systolic HTN received a diagnosis compared with 63% (systolic/diastolic); 32% with isolated systolic HTN received an initial antihypertensive compared with 52% (systolic/diastolic). Compared with patients with systolic/diastolic HTN, those with isolated systolic HTN had a 50% slower diagnosis rate (hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.41-0.60) and those with isolated diastolic HTN had a 26% slower rate (HR, 0.74; CI, 0.60-0.92). Patients with isolated systolic HTN had 58% slower medication initiation (HR, 0.42; CI, 0.34-0.51) and those with isolated diastolic HTN had 31% slower rates (HR, 0.69; CI, 0.55-0.86). Young adults with isolated systolic HTN have lower diagnosis and treatment rates.
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI.|Health Innovation Program, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Johnson
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI.|Health Innovation Program, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Bartels
authors.affiliation: Health Services Research and Development, Veterans Affairs Pittsburgh Healthcare System and Department of Pharmacy & Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Carolyn T
authors.initials: CT
authors.lastname: Thorpe
authors.affiliation: Health Innovation Program, University of Wisconsin School of Medicine and Public Health, Madison, WI.|Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Schumacher
authors.affiliation: Health Innovation Program, University of Wisconsin School of Medicine and Public Health, Madison, WI.|Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Nancy
authors.initials: N
authors.lastname: Pandhi
authors.affiliation: Health Innovation Program, University of Wisconsin School of Medicine and Public Health, Madison, WI.|Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI.|Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI.|Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D003937:Diagnosis, Differential; D003971:Diastole / Q000187:drug effects / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D013599:Systole / Q000187:drug effects / Q000502:physiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents