Factors Associated with Antihypertensive Therapy Prescription in Youth Delaware Medicaid Recipients with Primary Hypertension Diagnosis

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Author(s)Baker-Smith, Carissa M.
Author(s)McDuffie, Mary J.
Author(s)Nescott, Erin P.
Author(s)Akins, Robert E.
Date Accessioned2024-01-29T20:14:50Z
Date Available2024-01-29T20:14:50Z
Publication Date2023-10-21
DescriptionThis 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.
AbstractBACKGROUND 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
SponsorAccess to health care claims data was supported by funding to Dr. Baker-Smith from the Delaware INBRE program, the National Institute of General Medical Sciences at the National Institutes of Health and the state of Delaware (P20 GM103446).
CitationCarissa 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
ISSN1941-7225
URLhttps://udspace.udel.edu/handle/19716/33936
Languageen_US
PublisherAmerican Journal of Hypertension
Keywordsantihypertensive medication
Keywordsarea deprivation
Keywordsblood pressure
Keywordshypertension
KeywordsMedicaid
KeywordsPediatrics
TitleFactors Associated with Antihypertensive Therapy Prescription in Youth Delaware Medicaid Recipients with Primary Hypertension Diagnosis
TypeArticle
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