“They’re younger… it’s harder.” Primary providers’ perspectives on hypertension management in young adults: a multicenter qualitative study

Abstract

BackgroundYoung adults (18–39 year-olds) have the lowest hypertension control rates among adults with hypertension in the United States. Unique barriers to hypertension management in young adults with primary care access compared to older adults have not been evaluated. Understanding these differences will inform the development of hypertension interventions tailored to young adults. The goals of this multicenter study were to explore primary care providers’ perspectives on barriers to diagnosing, treating, and controlling hypertension among young adults with regular primary care.MethodsPrimary care providers (physicians and advanced practice providers) actively managing young adults with uncontrolled hypertension were recruited by the Wisconsin Research & Education Network (WREN), a statewide practice-based research network. Semi-structured qualitative interviews were conducted in three diverse Midwestern clinical practices (academic, rural, and urban clinics) using a semi-structured interview guide, and content analysis was performed.ResultsPrimary care providers identified unique barriers across standard hypertension healthcare delivery practices for young adults. Altered self-identity, greater blood pressure variability, and unintended consequences of medication initiation were critical hypertension control barriers among young adults. Gender differences among young adults were also noted as barriers to hypertension follow-up and antihypertensive medication initiation.ConclusionsTailored interventions addressing the unique barriers of young adults are needed to improve population hypertension control. Augmenting traditional clinic structure to support the “health identity” of young adults and self-management skills are promising next steps to improve hypertension healthcare delivery.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2332-8) contains supplementary material, which is available to authorized users.

Use of antihypertensive medication after ischemic stroke in young adults and its association with long-term outcome

“…Antihypertensive therapy is proven to reduce the rate of recurrent stroke, based on a number of randomized, placebo-controlled trials [7][8][9]. However, regular and lifelong use of antihypertensive medication in young adults is a particular challenge given the life-long need for medication use, altered self-identity, greater blood pressure variability compared to older adults and possible side effects of medication [10].…”

The Structure of Pharmacotherapy of Arterial Hypertension and Adherence in Young Patients

“…возрастным. Молодые пациенты с артериальной гипертензией в этом отношении наименее обследованы, хотя в последние годы получены данные зарубежных ученых [10,11]. Следует указать, однако, на то, что в условиях различных экономических систем, систем здравоохранения вклад факторов, влияющих на приверженность терапии, существенно различается [12].…”

My Hypertension Education and Reaching Target (MyHEART): Development and Dissemination of a Patient-Centered Website for Young Adults with Hypertension

“…Prior studies [ 31 , 32 , 37 ] that informed the MyHEART website development were approved by the University of Wisconsin-Madison Health Sciences Institutional Review Board (IRB) and informed consent was obtained from patient and clinician stakeholders. Neither IRB approval nor written consent were needed to design or implement this website because the data that informed MyHEART development was already described in the original IRB submission for the prior studies.…”

“…To further understand barriers to young adults achieving hypertension control, we engaged racially and ethnically diverse young adults in 6 focus groups and conducted one-on-one interviews with primary care providers [ 31 , 32 ]. Two focus groups were conducted at each site: 1 academic, 1 urban, and 1 rural healthcare system [ 31 , 32 ]. The young adult respondents identified hypertension education topics that were not commonly addressed in current educational materials [ 32 ].…”

“…Young adult respondents shared their preferred social media channels and requested Web-based education to provide flexible access to hypertension information “when they wanted it” [ 32 ]. Primary care providers shared similar views of lacking hypertension materials and/or the time for extended education for young adults [ 31 ]. Both groups also highlighted other common barriers (eg, transportation, work-life balance, financial limitations) to hypertension care delivery.…”