Differential Diagnosis and Treatment Rates Between Systolic and Diastolic Hypertension in Young Adults: A...

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Hypertension (HTN) control remains a challenge in young adults.
• Differential diagnosis and treatment rates based on HTN type may underlie poor control.
• Understanding these disparities is crucial for improving hypertension management in younger populations.

Purpose of the Study:

• To compare the rates of hypertension diagnosis and antihypertensive medication initiation among young adults with isolated systolic, isolated diastolic, and combined systolic/diastolic hypertension.
• To identify potential disparities in care based on hypertension subtype in patients aged 18 to 39 years.

Main Methods:

• Retrospective analysis of 3003 patients aged 18 to 39 years with incident hypertension.
• Kaplan-Meier survival analysis and Cox proportional hazards models were used to compare diagnosis and treatment rates across hypertension subtypes.
• Hazard ratios (HR) and 95% confidence intervals (CI) were calculated to quantify differences.

Main Results:

• Only 56% of young adults with isolated systolic HTN received a diagnosis, compared to 63% with combined HTN.
• Antihypertensive medication initiation was observed in 32% of isolated systolic HTN cases versus 52% of combined HTN cases.
• Patients with isolated systolic HTN had a 50% slower diagnosis rate (HR: 0.50) and 58% slower medication initiation (HR: 0.42) compared to those with combined HTN.

Conclusions:

• Young adults with isolated systolic hypertension experience significantly lower rates of diagnosis and treatment initiation compared to those with combined systolic/diastolic hypertension.
• Similar, though less pronounced, disparities were observed for isolated diastolic hypertension.
• These findings highlight critical gaps in hypertension care for young adults, particularly those with isolated systolic hypertension, necessitating targeted interventions.