Investigating the Relationship Between Blood Pressure, Blood Pressure Specific Knowledge, and Cardiovascular Risk Factors in College Students

Abstract

Cardiovascular disease (CVD) continually emerges as a leading cause of death globally. Hypertension, also known as high blood pressure, has been identified as one of the largest modifiable risk factors for CVD, though it remains highly prevalent. College-aged students require special consideration given recent studies highlighting higher-than-expected levels of elevated blood pressure and hypertension in college students. Additionally, little research has focused on the role of blood pressure specific knowledge within college students. The present study aimed to replicate prior findings on prevalence of elevated blood pressure in college students while also investigating the relationship between identified risk factors (weight, diet, physical activity, sleep, anxiety, and depression, rurality status, income level) blood pressure knowledge, and blood pressure. Additionally, the present study aimed to investigate what factors best predict hypertension knowledge in college students. Participants recruited from two universities (n=297) completed measures of various health behaviors, blood pressure specific knowledge, and sociodemographic information. Weight and blood pressure were collected in-lab by trained research assistants. The average age of participants was 19 years old (M = 19.33, SD = 2.41), and the majority of the sample was female (n = 187, 63%) and White (n = 168, 56.6%). As hypothesized, 30% of the sample fell within elevated blood pressure, stage 1 hypertension, or stage 2 hypertension. Interestingly, most individuals with elevated blood pressure or hypertension were unaware of their hypertensive status (n = 74, 24.9% of total sample, 83% of those with elevated blood pressure or hypertension). Systolic blood pressure was associated with lower diet quality (r = -0.15, p = .006) and higher weight (r = 0.47, p < .001). Fewer hours of sleep nightly (r = 0.10, p = 0.4) and higher weight (r = 0.149, p = .005) were associated with higher diastolic blood pressure. Lower systolic blood pressure was associated with higher depressive symptom endorsement (r = -0.116, p = .02) and lower alcohol use was with higher diastolic blood pressure (r = -0.12, p = .020). Regarding factors predicting blood pressure knowledge, only Other Race classification (b = 1.142, p = .003) and weight (b = .04, p = .016) significantly predicted hypertension knowledge. Other variables did not independently predict hypertension knowledge. Overall, the present study highlights a notable prevalence of elevated blood pressure and hypertension in college students and a lack of self-knowledge about blood pressure status. This study also replicated prior findings of the relationship between weight, diet quality, and blood pressure in a relatively young sample. Overall, this highlights the need for future research to investigate factors influencing personal blood pressure awareness in college students.