Hypertension detection, treatment and control in young adults in Australia

Abstract

Young adult hypertension increases risk of future cardiovascular disease but is often overlooked. We aimed to identify opportunities to reduce blood pressure among younger adults by determining the drivers of hypertension detection, treatment and control in young adults in Australia. A cross-sectional analysis of adults aged 18 to 39 years using nationally representative 2017-18 National Health Survey data was conducted. Hypertension was defined as measured blood pressure ≥140/90 mmHg and/or antihypertensive medication use. Outcomes included the proportion of people with hypertension who self-reported (detection), who were taking ≥1 antihypertensive class (treatment), and whose blood pressure was controlled (control). Control was defined as taking ≥1 class of antihypertensive and having systolic <140 mmHg and diastolic blood pressure <90 mmHg. Analyses were by stratified by sex, health services interaction, geographical location and socioeconomic status, with subgroup analyses among those with cardiometabolic risk factors. The survey sample (n = 5217) was representative of N = 7,533,625 adults aged 18 to 39 years (49.9% women). Hypertension prevalence was 10.7% (95% CI: 9.6% to 11.7%). Among those with hypertension, detection was 9.4%, treatment was 6.8% and control was 4.5%. Young adults who had a recent blood pressure check and resided in major cities had higher detection, treatment and control rates than their counterparts, potentially due to greater access to healthcare. In conclusion, these findings suggest that there is a need to better detect and manage hypertension in young adults, potentially by developing tailored approaches that are specific to different contexts and ultimately supporting prevention of cardiovascular disease in later life.