High BP linked with unmet social needs among young U.S. adults
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Key takeaways:
- Hypertension is prevalent in around 5% of youth and young adults in the U.S.
- Unmet social needs such as education, income, insurance, food and employment may significantly contribute to high BP in young adults.
Hypertension remains a prevalent concern among youth and young adults in the U.S., especially among those living with adverse social conditions, speakers reported.
Two studies evaluating hypertension in adolescents and young adults were presented at the Hypertension Scientific Sessions.
Both analyses utilized data from the 2017 to 2020 NHANES survey.
“Having more recent estimates is important,” Ahlia Sekkarie, PhD, epidemiologist in the division for heart disease and stroke prevention at the CDC, said in a press release. “Youth who have high blood pressure are more likely to have high blood pressure as adults, putting them at greater risk for heart disease and stroke.”
Hypertension in youth
In 2017, the American Academy of Pediatrics issued its updated guidelines on the screening and management of hypertension in children and adolescents and published it in Pediatrics.
Sekkarie and colleagues evaluated trends in hypertension prevalence among 2,600 youths aged 8 to 19 years since the release of the updated guidance.
The researchers reported the prevalence estimates of elevated BP among youth and adolescents was 8.7% (95% CI, 6.9-10.6) and the prevalence of hypertension was 5.4% (95% CI, 4-6.7).
The estimated prevalence of elevated BP and hypertension was increased among boys and young men and those with severe obesity, and increased with age, according to the study.
Researchers estimated Hispanic youth had the lowest prevalence of elevated BP compared with other races/ethnicities.
The researchers also evaluated the percentile-based thresholds and adult BP thresholds as laid out in the 2017 guideline to screen for hypertension among adolescents aged 13 to 17 years.
Sekkarie and colleagues reported the prevalence of elevated BP and hypertension prevalence was similar using both the percentile thresholds and the adult threshold.
“Our knowledge of current national estimates could be valuable to help inform policies and programs to support cardiovascular health in youth,” Sekkarie said in the release. “A healthy diet and regular exercise are important to reducing the risk of high blood pressure. Ensuring that youth are eating a healthy diet and getting enough physical activity is crucial to helping prevent heart disease and stroke.”
Hypertension in young adults
For the second analysis presented at the meeting, Thomas Alexander, BA, an MD candidate at Northwestern University Feinberg School of Medicine, and colleagues assessed the impact of social needs including education, income, insurance status, food insecurity and employment on hypertension among 3,720 young, middle-aged and older adults.
Young adults — those aged 18 to 39 years — had a hypertension prevalence of 22.7% and were more likely than middle-aged or older adults to be unaware of their hypertension status or to be untreated (P < .001).
Young adults with hypertension were also more likely to be uninsured, food insecure and low income compared to older adults, according to the study.
Moreover, adults with hypertension and two or more unmet social needs were more likely to be untreated compared with those with no unmet social needs (OR = 1.79; 95% CI 1.15- 2.78; P = .009) and were also more likely to have uncontrolled hypertension (OR = 1.71; 95% CI, 1.27-2.32; P < .001).
“Social determinants of health are the social conditions arising from where people are born, live, learn, work and mature,” Alexander said in the release. “Young adults with social needs and high blood pressure, need more support to achieve blood pressure goals. Our study highlights that addressing these social determinants through targeted public health strategies is essential to improve outcomes and prevent long-term heart disease and stroke complications in this vulnerable population.”
Reference:
- Flynn JT, et al. Pediatrics. 2017;doi:10.1542/peds.2017-1904.
- Sekkarie A, et al. Abstract MP19. Presented at: Hypertension Scientific Sessions; Sept. 5-8, 2024; Chicago.
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Alexander TJ, et al. Abstract MP21. Presented at: Hypertension Scientific Sessions; Sept. 5-8, 2024; Chicago.
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