Health care provider lifestyle modification advice for adults with hypertension in the United States

Background: Health care providers’ (HCP) advice for lifestyle modification is critical in the management and treatment of hypertension among adults. However, recent examination of the differences in receiving advice for lifestyle modification from HCP to adults with hypertension (HTN) by sociodemographic characteristics is limited. Materials and methods: Data were obtained from the 2017-2018 national health and nutrition examination survey (n=1,524; representing 57 million Americans). HCP advice on lifestyle modification was defined in four categories (advice to control/lose weight, exercise, reduce salt in diet, and reduce fat/calories). Sociodemographic differences by HCP advice were evaluated using weighted adjusted logistic regression models for each outcome. Results: Among the sample of adults with HTN, 42.3% received HCP advice to lose weight, 59% received advice to exercise, 49.2% received advice to reduce salt, and 46.4% received advice to reduce calories. Black (vs. White) adults with HTN had about twice and thrice higher odds of receiving HCP advice to exercise and reduce salt, respectively (95% CI: 1.12-2.51, 1.73-3.81). Adults aged 40-64 (vs. aged 18-39) had twice higher odds of receiving advice to lose weight (95% CI: 1.25-4.10). Adults who had no health insurance coverage (vs. those with health insurance coverage) had lower odds of receiving HCP advice to reduce calories/fat (OR: 0.53, 95% CI: 0.29-0.96). Conclusion: HCPs are generally not advising lifestyle modification for the U.S. adults with HTN, and the likelihood of receiving advice differs by sociodemographic characteristics. HTN treatment and control strategies should prioritize HCP increasing lifestyle modification advice and equity in care for the U.S. adults.