Double the Prevalence of Stage 2 Hypertension Readings in a Small Group of American Pre-clinical Medical Students Compared to Young Adults Diagnosed with Stage 2 Hypertension in the United States

Objective The aim of this study is to compare the prevalence of hypertension (HTN) in pre-clinical (first- and second-year) medical students at Lincoln Memorial University to that of the United States population and identify risk factors in this group. Materials and Methods Students from the DeBusk College of Osteopathic Medicine completed a survey that queried age, gender, tobacco use, alcohol consumption, diet, aerobic exercise, mental health, social support, amount of sleep per night, and past medical history. Omron BP710N (Omron 3 series) sphygmomanometers were used to measure blood pressures in the left arm. Waist circumference was measured around the umbilicus. HTN stages were defined under the 2017 ACC/AHA guidelines. Univariate, binominal, and multinomial regression analyses of risk factors were performed using SPSS v22.0 with α = 0.05. Results Of the 213 students surveyed, 49.8% (106/213) were males, 49.3% (105/213) were females, and 0.9% (2/213) declined to reveal their gender. The mean age of the sample was 25.8 years (SD = 2.75 years) and the range was between 21 and 37 years. Under the 2017 ACC/AHA guidelines, 36.6% (78/213) were normotensive; 16.4% (35/213) had elevated blood pressure; 29.1% (62/213) had stage 1 HTN; and 17.8% (38/213) had stage 2 HTN. A multinomial logistic regression model was significant, χ(2)(9) = 82.934, p < 0.001, explained 34.9% (Nagelkerke R(2)) of the variance in HTN, and correctly classified 50.2% of cases. In comparison to normotensive females, normotensive males are 2.81 times more likely (95% CI: 1.04-7.61; p = 0.042) to develop stage 2 HTN; increasing waist circumference by 1 cm in normotensive students was associated with a 10% increase (95% CI: 1.06-1.15; p < 0.001) in developing stage 2 HTN; and sleeping <6 hours per night was associated with 4.33 times increased (95% CI: 1.52-12.34; p = 0.006) likelihood of developing stage 2 HTN with respect to normotensive students who sleep for 6-8 hours a night. Conclusion Our sample of medical students has a 2.4 times higher prevalence of stage 2 HTN readings in comparison to adults aged 18-39 according to the 2015-2016 national CDC hypertension prevalence report. Risk factors including male gender and sleeping less than 6 hours per night are significant predictors of elevated and stage 2 HTN. Waist circumference is predictive of stage 1 HTN and stage 2 HTN. Additional studies should be conducted to increase the sample size in order to better assess the prevalence of stage 2 HTN in American medical students.