{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T09:03:42Z","timestamp":1784106222160,"version":"3.55.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Blood pressure control among adults &amp;lt;65 years old with public, private, or no healthcare insurance after the US 2010 Affordable Care Act (ACA) is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>National Health and Nutrition Examination Surveys were analyzed pre- (2001-2010) and post-ACA (2015-2023) on adults aged 20-64 years (pre-Medicare eligibility) with hypertension (systolic \u2265140 or diastolic blood pressure \u226590 mmHg, or antihypertensive therapy). Relationships of blood pressure control (&amp;lt;140\/&amp;lt;90 mmHg) to healthcare insurance and social determinants (race\/ethnicity, low income [&amp;lt;200% federal poverty]) were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among adults 20-64 years with hypertension pre- vs post-ACA, the uninsured (17.2% vs 11.4%) and the privately insured declined (64.3% vs 56.0%), while the publicly insured increased (16.2% vs 28.5%). Non-Hispanic Black and Hispanic adults comprised lower percentages of privately than publicly or uninsured adults, respectively, pre-ACA (18.9% vs 37.3%, 42.4%) and post-ACA (24.1% vs 38.3%, 50.3%). Low incomes were less frequent for privately insured adults than for publicly insured or uninsured adults, respectively, pre-ACA (13.0% vs 64.4%, 64.9%) and post-ACA (11.3% vs 67.6%, 63.1%). Blood pressure control was not different pre-ACA for publicly and privately insured adults (54.3% vs 50.4%, P\u2009=\u2009.064) and lower among uninsured adults (30.5%) than both insured groups, with a similar pattern post-ACA (54.5% [public], 50.2% [private], 30.3% [uninsured]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this US population-based study, blood pressure control was not different for publicly and privately insured adults pre- and post-ACA, although lower for uninsured adults. Public healthcare insurance appeared to continue mitigating the effects of adverse social determinants on blood pressure control post-ACA, despite the increase in publicly insured adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajh\/hpag036","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T11:30:45Z","timestamp":1776771045000},"page":"1013-1020","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare insurance status and hypertension control before and after the Affordable Care Act"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1470-5875","authenticated-orcid":false,"given":"Brent M","family":"Egan","sequence":"first","affiliation":[{"name":"Medical University of SC Department of Medicine, , Charleston, SC,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiexiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Mathematics, College of Charleston , Charleston, SC,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan E","family":"Sutherland","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of SC School of Medicine-Greenville , Greenville, SC,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael K","family":"Rakotz","sequence":"additional","affiliation":[{"name":"American Medical Association, Center for Optimal Health Outcomes , Chicago, IL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"2026071504093664700_hpag036-B1","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1161\/HYPERTENSIONAHA.114.04276","article-title":"The growing gap in hypertension control between insured and uninsured adults: NHANES 1988\u20132010","volume":"64","author":"Egan","year":"2014","journal-title":"Hypertension"},{"key":"2026071504093664700_hpag036-B2","doi-asserted-by":"crossref","first-page":"e2249930","DOI":"10.1001\/jamanetworkopen.2022.49930","article-title":"Blood pressure control among Black and White adults following a quality improvement program in a large integrated health system","volume":"6","author":"Harrison","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2026071504093664700_hpag036-B3","author":"Million Hearts","year":"2024"},{"key":"2026071504093664700_hpag036-B4","volume-title":"Increase Control of High Blood Pressure in Adults\u2014Heart Disease and Stroke, HDS-05 Revised 2022. 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