Hypertension Prevalence and Control Among U.S. Women of Reproductive Age

Abstract

Introduction: Hypertension is a risk factor for cardiovascular disease, a leading cause of death among women of reproductive age (WRA, women aged 18–44 years). This study estimated hypertension prevalence and control among WRA at the national and state levels using electronic health record (EHR) data.Methods: Non-pregnant WRA were included in this cross-sectional study using 2019 IQVIA™ Ambulatory Electronic Medical Records – US national data (analyzed in 2023). Suspected hypertension was identified using any of these criteria: ≥1 hypertension diagnosis code, ≥2 blood pressure (BP) readings ≥140/90 mmHg on separate days, or ≥1 antihypertensive medication. Among WRA with hypertension, the latest BP in 2019 was used to identify hypertension control (BP <140/90 mmHg). Estimates were age standardized and stratified by race or Hispanic ethnicity, region, and states with sufficient data. Tukey tests compared estimates by race or Hispanic ethnicity, region, and comorbidities.Results: Among 2,125,084 WRA (62.1% White, 8.8% Black, and 29.1% other [including Hispanic, Asian, other, or unknown]) with a mean age of 31.7 years, hypertension prevalence was 14.5%. Of those with hypertension, 71.9% had controlled BP. Black WRA had a higher hypertension prevalence (22.3% vs. 14.4%, p<0.05) but lower control (60.6% vs. 73.9%, p<0.05) than White WRA. State-level hypertension prevalence ranged from 13.7% (Massachusetts) to 36% (Alabama), and control ranged from 82.9% (Kansas) to 59.2% (the District of Columbia).Conclusions: This study provides the first state-level estimates of hypertension control among WRA. EHR data complements traditional hypertension surveillance data and provides further information for efforts to prevent and manage hypertension among WRA.