Limitations
hypertension
HYPERTENSION
This study has limitations. The dropout rate was higher than expected but did not differ by study group. The latter part of the study overlapped with the COVID-19 pandemic; however, there was greater study dropout or loss to follow-up prior to the pandemic. It is possible that stay-at-home orders may have provided participants with more time to invest in health or research studies. The reasons identified for study dropout were more likely related to social determinants of health and other routine life factors experienced in the young adult population, such as pregnancy, relocation, or the perception of being too busy. Transportation was also a reported reason for study dropout. In consideration of future trial designs and successful trial conduct in young adults, the study team recommends promoting ongoing engagement opportunities throughout the study and identifying and developing resources for supporting social determinants of health as well as social and community support unique to young adults.Although our intervention did not include prescribing medication, the objective of this study was to demonstrate effective and sustainable resources to support routine clinical care. Since approximately 50% of participants from both groups were not receiving antihypertensive medication at baseline, future interventions combining components of the MyHEART program in a clinic with a partnered clinician to prescribe guideline-directed antihypertensive medication initiation and/or stepped titration may demonstrate more significant BP lowering and hypertension control.