Hypertension and Diabetes in Non-Pregnant Women of Reproductive Age in the United States

Olumayowa Azeez, MPH, CHES; Aniket Kulkarni, MBBS, MPH; Elena V. Kuklina, MD, PhD; Shin Y. Kim, MPH; Shanna Cox, MSPH

Disclosures

Prev Chronic Dis. 2019;16(10):e146 

In This Article

Abstract and Introduction

Abstract

Introduction: Diagnosis and control of chronic conditions have implications for women's health and are major contributing factors to maternal and infant morbidity and mortality. This study estimated the prevalence of hypertension and diabetes in non-pregnant women of reproductive age in the United States, the proportion who were unaware of their condition or whose condition was not controlled, and differences in the prevalence of these conditions by selected characteristics.

Methods: We used data from the 2011–2016 National Health and Nutrition Examination Survey to estimate overall prevalence of hypertension and diabetes among women of reproductive age (aged 20–44 y), the proportion who were unaware of having hypertension or diabetes, and the proportion whose diabetes or hypertension was not controlled. We used logistic regression models to calculate adjusted prevalence ratios to assess differences by selected characteristics.

Results: The estimated prevalence of hypertension was 9.3% overall. Among those with hypertension, 16.9% were unaware of their hypertension status and 40.7% had uncontrolled hypertension. Among women with diabetes, almost 30% had undiagnosed diabetes, and among those with diagnosed diabetes, the condition was not controlled in 51.5%.

Conclusion: This analysis improves our understanding of the prevalence of hypertension and diabetes among women of reproductive age and may facilitate opportunities to improve awareness and control of these conditions, reduce disparities in women's health, and improve birth outcomes.

Introduction

Hypertension is the leading risk factor for heart disease and stroke, the first and fourth major causes of death in the United States, respectively.[1] Hypertension is a major contributing factor to maternal and fetal morbidity, complicating up to 5% of the estimated 4 million pregnancies in the United States annually.[2] Hypertension at a young age increases the risk of heart disease over the lifetime.[3–5] Women with chronic hypertension and women with pregnancy-related hypertension have an increased risk of life-threatening maternal and infant outcomes, such as placental abruption, pulmonary edema, stroke, renal failure, preterm birth, intrauterine growth restriction, and death.[2,6]

Diabetes is another one of the most common chronic diseases in the United States.[7] Approximately 13% of adults (aged ≥20) have diabetes; 9.6% have physician-diagnosed diabetes and 3.0% have undiagnosed diabetes.[4] For women of reproductive age, detection and management of pre-existing diabetes can help avoid the risks for poor maternal and infant outcomes.[8] Among women with pre-existing diabetes, failure to properly control diabetes before conception and during the initial trimester of pregnancy increases risks for major birth defects and stillbirths. Failure to properly control diabetes during the last 2 trimesters can lead to large-for-gestational-age babies, which could pose risks for both mother and child.

Overall, the prevalence of chronic disease among women of reproductive age in the United States has increased, and improving women's health during their reproductive years may improve the health of future generations.[9] The objective of this study was to estimate the prevalence of hypertension and diabetes in non-pregnant women of reproductive age in the United States, the proportion of these women who were unaware of their condition or whose condition was not controlled, and differences in the prevalence of these conditions by selected characteristics.

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