Factors Associated With Not Having a Healthcare Visit in the Past Year Among US Adults With Hypertension: Data From NHANES 2013–2018

• Published in: American journal of hypertension Vol. 35; no. 2; pp. 132 - 141
• Main Authors: Akinyelure, Oluwasegun P, Hubbard, Demetria, Sakhuja, Swati, Hardy, Shakia T, Oparil, Suzanne, Cherrington, Andrea L, Reynolds, Kristi, Wozniak, Gregory, Muntner, Paul
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01-02-2022
• Subjects: Adult; Antihypertensive Agents - therapeutic use; Blood Pressure - physiology; Delivery of Health Care; Humans; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - epidemiology; Nutrition Surveys; Original; blood pressure; healthcare utilization; blood pressure control; doctor’s visit; hypertension; healthcare visit
• ISSN: 0895-7061; 1941-7225
• DOI: 10.1093/ajh/hpab153

Abstract
Background
Not having a healthcare visit in the past year has been associated with a higher likelihood of uncontrolled blood pressure (BP) among individuals with hypertension.
Methods
We examined factors associated with not having a healthcare visit in the past year among US adults with hypertension using data from the US National Health and Nutrition Examination Survey 2013–2018 (n = 5,985). Hypertension was defined as systolic BP (SBP) ≥140 mm Hg, diastolic BP (DBP) ≥90 mm Hg, or antihypertensive medication use. Having a healthcare visit in the past year was self-reported.
Results
Overall, 7.0% of US adults with hypertension reported not having a healthcare visit in the past year. Those without vs. with a healthcare visit in the past year were less likely to be aware they had hypertension (45.0% vs. 83.9%), to be taking antihypertensive medication (36.7% vs. 91.4%, among those who were aware they had hypertension), and to have controlled BP (SBP/DBP <140/90 mm Hg; 9.1% vs. 51.7%). After multivariable adjustment, not having a healthcare visit in the past year was more common among US adults without health insurance (prevalence ratio [PR]: 2.22; 95% confidence interval [CI] 1.68–2.95), without a usual source of healthcare (PR: 5.65; 95% CI 4.16–7.67), who smoked cigarettes (PR: 1.34; 95% CI 1.02–1.77), and with heavy vs. no alcohol consumption (PR: 1.55; 95% CI 1.16–2.08). Also, not having a healthcare visit in the past year was more common among those without diabetes or a history of atherosclerotic cardiovascular disease, and those not taking a statin.
Conclusions
Interventions should be considered to ensure all adults with hypertension have annual healthcare visits.
Graphical Abstract