Factors Associated with Antihypertensive Therapy Prescription in Youth Delaware Medicaid Recipients with Primary Hypertension Diagnosis
Date
2023-10-21
Journal Title
Journal ISSN
Volume Title
Publisher
American Journal of Hypertension
Abstract
BACKGROUND
Higher neighborhood deprivation is associated with hypertension diagnosis in youth. In this study, we assess if there is an association between neighborhood deprivation and antihypertensive therapy prescription among insured youth with a primary hypertension diagnosis.
METHODS
Using a retrospective cross-sectional design, we assessed the proportion of youth with a diagnosis of primary hypertension prescribed antihypertensive therapy. We evaluated the proportion of youth prescribed antihypertensive therapy and compared prescribing patterns by area deprivation index (ADI), age, sex, obesity diagnosis, race, ethnicity, and duration of Medicaid coverage.
RESULTS
Of the 65,452 non-pregnant Delaware Medicaid recipients, 8–18 years of age, 1,145 (1.7%) had an International classification of diseases (ICD)-9/ICD-10 diagnosis of primary hypertension; 165 of the 1,145 (14%) were prescribed antihypertensive therapy. Factors associated with a greater odds of prescription by multivariable logistic regression were age, obesity diagnosis, and duration of Medicaid full benefit coverage. Odds of antihypertensive therapy prescription did not vary by race, ethnicity, or ADI.
CONCLUSIONS
Antihypertensive therapy prescription rates are poor despite national guideline recommendations. Among youth receiving Delaware Medicaid between 2014 and 2019, prescription proportions were highest among youth of older age, with an obesity diagnosis, and among youth with longer duration of Medicaid benefit coverage. Although high area deprivation has been shown to be associated with the diagnosis of hypertension, high vs. low area deprivation was not associated with greater antihypertensive therapy prescription among youth with primary hypertension. Our finding of a mismatch between hypertension diagnosis and antihypertensive therapy prescription highlights a potential disparity in antihypertensive therapy prescription in youth.
Graphical abstract available at: https://doi.org/10.1093/ajh/hpad098
Description
This is a pre-copyedited, author-produced version of an article accepted for publication in American Journal of Hypertension following peer review. The version of record Carissa M Baker-Smith, Mary J McDuffie, Erin P Nescott, Robert E Akins, Factors Associated with Antihypertensive Therapy Prescription in Youth Delaware Medicaid Recipients with Primary Hypertension Diagnosis, American Journal of Hypertension, Volume 37, Issue 2, February 2024, Pages 143–149, https://doi.org/10.1093/ajh/hpad098 is available online at: https://doi.org/10.1093/ajh/hpad09. © The Author(s) 2023. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved. This article will be embargoed until 10/21/2024.
Keywords
antihypertensive medication, area deprivation, blood pressure, hypertension, Medicaid, Pediatrics
Citation
Carissa M Baker-Smith, Mary J McDuffie, Erin P Nescott, Robert E Akins, Factors Associated with Antihypertensive Therapy Prescription in Youth Delaware Medicaid Recipients with Primary Hypertension Diagnosis, American Journal of Hypertension, Volume 37, Issue 2, February 2024, Pages 143–149, https://doi.org/10.1093/ajh/hpad098