Home Blood Pressure Monitoring Among Adolescents and Young Adults, NHANES 2009-2014

BACKGROUND: Among middle-aged and older adults, home blood pressure (BP) monitoring (HBPM) is a tool for both diagnosis and management of hypertension. Pediatric guidelines recommend HBPM as an adjunct to office BP measurement among children and adolescents with hypertension. Little is known about the prevalence and frequency of HBPM in the United States among youth with hypertension, and what factors are associated with HBPM use. METHODS: We examined data from NHANES (National Health and Nutrition Examination Survey) 2009-2014 cycles to determine HBPM use in adolescents (16 to <20 years) and young adults (20 to <25 years), n = 2,919. HBPM frequency was defined as none, less than once a month, or at least monthly. Using multivariable logistic regression, we assessed the association between HBPM and sociodemographic factors including age, sex, race/ethnicity, obesity, income, insurance status, and education. RESULTS: An estimated 10.3% of adolescents and young adults reported performing HBPM in the past year. Of those with hypertension, 22.8% reported performing any HBPM in the past year. Compared to adolescents, a higher percentage of young adults reported performing HBPM (12.5% vs. 7.3%). In adjusted models, having health insurance (odds ratio [OR] 1.84 [95% confidence interval {CI} 1.25-2.73]), high school education or greater (OR 1.79 [95% CI 1.13-2.82]), and obesity (OR 1.83 [95% CI 1.10-3.05]) were associated with reporting any HBPM use. CONCLUSIONS: In this analysis of nationally representative US data, HBPM was reported in less than a quarter of adolescents and young adults with hypertension. Obesity, insurance status, and education were associated with any HBPM use.