Factors impacting poor hypertension control in young urban adults in a Malaysian primary care clinic.

Abstract

The prevalence of hypertension among young adults is increasing and with it the risk of cardiovascular events. Thus, this study was conducted to determine the prevalence and factors that are associated with poor BP control in young adults (18-39 years old) in a government primary healthcare centre in Klang Valley, Malaysia. This cross-sectional study analysed 191 hypertensive patients from the Tele-Primary Care (TPC) registry (Dec 2019-Dec 2020). BP control was defined using the Malaysian Clinical Practice Guidelines (CPG) 2018. The median (IQR) age of the patients were 36 (5) years and most of them were Malay (77.5%), married (41.9%) and employed (67.5%). Almost all had essential hypertension (98.4%). The prevalence of poor BP control was 78.0% with most having uncontrolled diastolic BP (67.0%). The median (IQR) BMI was 31.35 kg/m² with half the patients in obesity class 1 (50.3%) category. Most common comorbidity was dyslipidemia (72.0%) and diabetes mellitus (DM) (47.6%). Through multivariate logistic regression, having DM was independently associated with poor BP control (AOR = 6.591, 95% CI = 2.373, 18.306, p < 0.001). Poor BP control was worryingly high in young adults with hypertension, especially those with DM. Aggressive screening and stricter adherence to risk-stratified BP targets are essential.