Blood Pressure in Young Adults in Iowa

Abstract

Hypertension (HTN) is common among young adults, but often undiagnosed. Early diagnosis and management are crucial to prevent cardiovascular events. However, young adults are less aware of their HTN and are diagnosed less frequently. This study aims to identify adults aged 18–40 in Iowa with high blood pressure (HBP) and determine the percentage diagnosed with HTN and associated risk factors. This retrospective observational study analyzed electronic health records from the University of Iowa Healthcare outpatient, inpatient, and emergency departments between 2016 and 2022. We included adults aged 18–40 with at least three elevated BP readings (systolic ≥140 or diastolic ≥90). Patients were followed for 2 years to identify those diagnosed with HTN. Summary statistics were calculated, and a Cox regression model assessed the time to HTN diagnosis. We identified 22,299 adults with at least three HBP readings. Among 7,523 young adults with at least three elevated BP readings, only 17.4% received a HTN diagnosis within 2 years. Most diagnoses occurred in outpatient (57.2%), followed by emergency (24%) and inpatient (17.5%) settings. Young adults had a significantly longer time to diagnosis than older populations. Young males, African Americans, Hispanics, patients with diabetes or dyslipidemia, and patients with more healthcare visits had shorter times to diagnosis. In conclusion, 7,523 out of 22,299 (33.7%) patients with HBP were young adults, with only 17.4% diagnosed with HTN within 2 years. The low diagnosis rate is concerning, given the potential for long-term cardiovascular complications. Improved screening protocols and targeted interventions are needed to address age-related underdiagnosis.