Double the Prevalence of Stage 2 Hypertension Readings in a Small Group of American Pre-clinical Medical Students Compared to Young Adults Diagnosed with Stage 2 Hypertension in the United States.

Abstract

ObjectiveThe aim of this study is to compare the prevalence of hypertension (HTN) in pre-clinical (first- and second-year) medical students at Lincoln Memorial University to that of the United States population and identify risk factors in this group.Materials and MethodsStudents from the DeBusk College of Osteopathic Medicine completed a survey that queried age, gender, tobacco use, alcohol consumption, diet, aerobic exercise, mental health, social support, amount of sleep per night, and past medical history. Omron BP710N (Omron 3 series) sphygmomanometers were used to measure blood pressures in the left arm. Waist circumference was measured around the umbilicus. HTN stages were defined under the 2017 ACC/AHA guidelines. Univariate, binominal, and multinomial regression analyses of risk factors were performed using SPSS v22.0 with α = 0.05. ResultsOf the 213 students surveyed, 49.8% (106/213) were males, 49.3% (105/213) were females, and 0.9% (2/213) declined to reveal their gender. The mean age of the sample was 25.8 years (SD = 2.75 years) and the range was between 21 and 37 years. Under the 2017 ACC/AHA guidelines, 36.6% (78/213) were normotensive; 16.4% (35/213) had elevated blood pressure; 29.1% (62/213) had stage 1 HTN; and 17.8% (38/213) had stage 2 HTN. A multinomial logistic regression model was significant, χ2(9) = 82.934, p < 0.001, explained 34.9% (Nagelkerke R2) of the variance in HTN, and correctly classified 50.2% of cases. In comparison to normotensive females, normotensive males are 2.81 times more likely (95% CI: 1.04-7.61; p = 0.042) to develop stage 2 HTN; increasing waist circumference by 1 cm in normotensive students was associated with a 10% increase (95% CI: 1.06-1.15; p < 0.001) in developing stage 2 HTN; and sleeping <6 hours per night was associated with 4.33 times increased (95% CI: 1.52-12.34; p = 0.006) likelihood of developing stage 2 HTN with respect to normotensive students who sleep for 6-8 hours a night. ConclusionOur sample of medical students has a 2.4 times higher prevalence of stage 2 HTN readings in comparison to adults aged 18-39 according to the 2015-2016 national CDC hypertension prevalence report. Risk factors including male gender and sleeping less than 6 hours per night are significant predictors of elevated and stage 2 HTN. Waist circumference is predictive of stage 1 HTN and stage 2 HTN. Additional studies should be conducted to increase the sample size in order to better assess the prevalence of stage 2 HTN in American medical students.