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Cited by 134Blood Pressure and Hypertension StudiesHealth Promotion and Cardiovascular PreventionPrimary Care and Health Outcomes

Undiagnosed hypertension among young adults with regular primary care use

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Johnson, Heather M., Thorpe, Carolyn T., Bartels, Christie M., Schumacher, Jessica R., Palta, Mari, Pandhi, Nancy, Sheehy, Ann M., Smith, Maureen A.·2014·Journal of Hypertension
DOI 10.1097/hjh.0000000000000008PMC PMC3868024
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Abstract

OBJECTIVE: Young adults meeting hypertension diagnostic criteria have a lower prevalence of a hypertension diagnosis than middle-aged and older adults. The purpose of this study was to compare the rates of a new hypertension diagnosis for different age groups and identify predictors of delays in the initial diagnosis among young adults who regularly use primary care. METHODS: A 4-year retrospective analysis included 14 970 patients, at least 18 years old, who met clinical criteria for an initial hypertension diagnosis in a large, Midwestern, academic practice from 2008 to 2011. Patients with a previous hypertension diagnosis or prior antihypertensive medication prescription were excluded. The probability of diagnosis at specific time points was estimated by Kaplan-Meier analysis. Cox proportional hazard models (hazard ratio; 95% confidence interval) were fit to identify predictors of delays to an initial diagnosis, with a subsequent subset analysis for young adults (18-39 years old). RESULTS: After 4 years, 56% of 18-24-year-olds received a diagnosis compared with 62% (25-31-year-olds), 68% (32-39-year-olds), and more than 70% (≥40-year-olds). After adjustment, 18-31-year-olds had a 33% slower rate of receiving a diagnosis (18-24 years hazard ratio 0.66, 0.53-0.83; 25-31 years hazard ratio 0.68, 0.58-0.79) compared with adults at least 60 years. Other predictors of a slower diagnosis rate among young adults were current tobacco use, white ethnicity, and non-English primary language. Young adults with diabetes, higher blood pressures, or a female provider had a faster diagnosis rate. CONCLUSION: Provider and patient factors are critical determinants of poor hypertension diagnosis rates among young adults with regular primary care use.

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  • Few systematic, community-based studies have quantified the burden of undiagnosed hypertension in young adults in Pakistan.

    “While these risk factors are well documented globally, few systematic, community-based studies have quantified the burden of undiagnosed hypertension in young adults in Pakistan.”

    From Prevalence of Undiagnosed Hypertension in Young Adults: A Community-Based Study (2025) · cites this paper as [9]

    The Methods and Discussion describe a study of patients receiving primary care in a Midwestern U.S. healthcare system, not a community-based study in Pakistan. Searches for Pakistan and for a scarcity of systematic community-based studies found no passage addressing the claim about the Pakistani research literature. (LLM, conf=0.76)

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Authors
Johnson, H. M., Thorpe, C. T., Bartels, C. M., Schumacher, J. R., Palta, M., Pandhi, N., Sheehy, A. M., & Smith, M. A.
Affiliations
  • University of Wisconsin–Madison (US)
  • University of Pittsburgh (US)
Corresponding author
Johnson, Heather M.
ORCID
Venue
Journal of Hypertension
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2014-01
Volume
32
Issue
1
Pages
65-74
ISSN
0263-6352 (ISSN-L)
DOI
10.1097/hjh.0000000000000008
PMC
PMC3868024
OpenAlex
W2067896262
Cited by
134
References
4
Citations by year
2026: 9 · 2025: 13 · 2024: 9 · 2023: 12 · 2022: 12 · 2021: 10 · 2020: 13 · 2019: 12 · 2018: 7 · 2017: 11 · 2016: 12 · 2015: 10 · 2014: 4
FWCI
5.90
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Journal of Hypertension (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
  • Georgia Clinical and Translational Science Alliance
  • National Institutes of Health (UL1TR000427)
  • School of Medicine and Public Health, University of Wisconsin-Madison
  • National Institute on Aging (K08AG029527)
  • National Heart, Lung, and Blood Institute (K23HL112907)
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (K23AR062381)
  • National Center for Research Resources (UL1RR025011)
  • National Center for Advancing Translational Sciences (U54TR000021)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
Keywords
undiagnosed hypertension, young adults, hypertension diagnosis, delayed diagnosis, primary care, age differences in diagnosis, tobacco use, ethnicity, language barriers, diabetes mellitus, blood pressure
MeSH terms
Adolescent, Adult, Counseling, Female, Humans, Hypertension, Life Style, Male, Patient Education as Topic, Retrospective Studies, Incidental Findings, Young Adult

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