Prevalence, Awareness, Treatment, and Poor Control of Hypertension Among Young American Adults: Race-Stratified Analysis of the National Health and Nutrition Examination Survey

Objective: To evaluate the race-stratified trends for prevalence, awareness, treatment, and control of hypertension in young American adults aged 18 to 44 years. Patients and Methods: The National Health and Nutrition Examination Survey data from 2005–2016 for adults aged 18 to 44 years was used to calculate age-adjusted (using 2005, 2010, and 2015 US Census population proportions) weighted trends in prevalence, awareness, treatment, and control of hypertension among non-Hispanic white, non-Hispanic black, and Mexican-American participants as per the 2017 American College of Cardiology/American Heart Association guidelines. Trends were estimated by logistic regression models including demographic, socioeconomic, health care access, and Bonferroni correction for multiple comparisons as covariates. Results: Among 15,171 young American adults, stable trends for the prevalence, awareness, treatment, and control of hypertension was seen in all racial groups (P_{linear trend}>.05 for all). The prevalence from 2013 to 2016 was highest in non-Hispanic blacks (30.7%; 95% CI, 27.3 to 34.0%), followed by non-Hispanic whites (21.9%; 95% CI, 19.6 to 24.1%), and Mexican Americans (21.9%; 95% CI, 18.6 to 25.1%). The awareness was stable at ∼43.2% in non-Hispanic blacks, ∼34.8% in non-Hispanic whites, and ∼28.4% in Mexican Americans from 2005 to 2008 through 2013 to 2016. The stable treatment rates at nearly 34.4%, 23.7%, and 20.6%, were seen in non-Hispanic black, non-Hispanic white, and Mexican-Americans, respectively. The optimal control of hypertension was seen in 14.5% (95% CI, 12.1 to 17.0%) non-Hispanic blacks, 12.2% (95% CI, 10.3 to 14.0%) non-Hispanic whites, and 10.3% (95% CI, 7.1 to 13.5%) Mexican Americans from 2013 to 2016. Conclusion: Nearly one in every three non-Hispanic young black and one in every five young Mexican American and non-Hispanic white adults have hypertension. Our race-stratified analyses highlight the categorical need to improve the abysmal control of hypertension which is approximately 1 in 10 young adults.