Factors associated with not having a healthcare visit in the past year among US adults with hypertension: Data from NHANES 2013-2018.

BACKGROUND Not having a healthcare visit in the past year has been associated with a higher likelihood of uncontrolled blood pressure (BP) among individuals with hypertension. METHODS We examined factors associated with not having a healthcare visit in the past year among US adults with hypertension using data from the US National Health and Nutrition Examination Survey 2013-2018 (n=5,985). Hypertension was defined as systolic BP ≥140 mmHg, diastolic BP ≥90 mmHg, or antihypertensive medication use. Having a healthcare visit in the past year was self-reported. RESULTS Overall, 7.0% of US adults with hypertension reported not having a healthcare visit in the past year. Those without versus with a healthcare visit in the past year were less likely to be aware they had hypertension (45.0% versus 83.9%), to be taking antihypertensive medication (36.7% versus 91.4%, among those who were aware they had hypertension) and to have controlled BP (systolic/diastolic BP <140/90 mmHg; 9.1% versus 51.7%). After multivariable adjustment, not having a healthcare visit in the past year was more common among US adults without health insurance (prevalence ratio [PR]: 2.22; 95%CI 1.68-2.95), without a usual source of healthcare (PR: 5.65; 95%CI 4.16-7.67), who smoked cigarettes (PR: 1.34; 95%CI 1.02-1.77), and with heavy versus no alcohol consumption (PR: 1.55; 95%CI 1.16-2.08). Also, not having a healthcare visit in the past year was more common among those without diabetes or a history of atherosclerotic cardiovascular disease, and those not taking a statin. CONCLUSION Interventions should be considered to ensure all adults with hypertension have annual healthcare visits.