Hypertension in women of reproductive age in the United States: NHANES 1999-2008

Abstract

Objective: To examine the epidemiology of hypertension in women of reproductive age. Methods: Using NHANES from 1999-2008, we identified 5,521 women age 20-44 years old. Hypertension status was determined using blood pressure measurements and/or self-reported medication use. Results: The estimated prevalence of hypertension in women of reproductive age was 7.7% (95% confidence interval (CI): 6.9%-8.5%). The prevalence of anti-hypertensive pharmacologic therapy was 4.2% (95% CI 3.5%-4.9%). The prevalence of hypertension was relatively stable across the study period; the age and race adjusted odds of hypertension in 2007-2008 did not differ significantly from 1999-2000 (odds ratio 1.2, CI 0.8 to 1.7, p = 0.45). Significant independent risk factors associated with hypertension included older age, non-Hispanic black race (compared to non-Hispanic whites), diabetes mellitus, chronic kidney disease, and higher body mass index. The most commonly used antihypertensive medications included diuretics, angiotensin-converting enzyme inhibitors (ACE), and beta blockers. Conclusion: Hypertension occurs in about 8% of women of reproductive age. There are remarkable differences in the prevalence of hypertension between racial/ethnic groups. Obesity is a risk factor of particular importance in this population because it affects over 30% of young women in the U.S., is associated with more than 4 fold increased risk of hypertension, and is potentially modifiable.