Open AccessDifferential Diagnosis and Treatment Rates Between Systolic and Diastolic Hypertension in Young Adults: A Multidisciplinary Observational Study
Author(s) -
Johnson Heather M.,
Bartels Christie M.,
Thorpe Carolyn T.,
Schumacher Jessica R.,
Pandhi Nancy,
Smith Maureen A.
Publication year - 2015
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12596
Subject(s) - medicine , diastole , hazard ratio , cardiology , blood pressure , systolic hypertension , systole , isolated systolic hypertension , proportional hazards model , observational study , confidence interval
Differential rates of diagnosis and treatment by hypertension ( HTN ) type may contribute to poor HTN control in young adults. The objective of this study was to compare rates of receiving a hypertension diagnosis and antihypertensive agent among young adults with (1) isolated systolic, (2) isolated diastolic, and (3) combined systolic/diastolic HTN . A retrospective analysis was conducted in patients aged 18 to 39 years (n=3003) with incident HTN . Kaplan–Meier survival and Cox proportional hazards analyses were performed. Only 56% with isolated systolic HTN received a diagnosis compared with 63% (systolic/diastolic); 32% with isolated systolic HTN received an initial antihypertensive compared with 52% (systolic/diastolic). Compared with patients with systolic/diastolic HTN , those with isolated systolic HTN had a 50% slower diagnosis rate (hazard ratio [ HR ], 0.50; 95% confidence interval [ CI ], 0.41–0.60) and those with isolated diastolic HTN had a 26% slower rate ( HR , 0.74; CI , 0.60–0.92). Patients with isolated systolic HTN had 58% slower medication initiation ( HR , 0.42; CI , 0.34–0.51) and those with isolated diastolic HTN had 31% slower rates ( HR , 0.69; CI , 0.55–0.86). Young adults with isolated systolic HTN have lower diagnosis and treatment rates.