Report: High blood pressure is dangerously neglected

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A comprehensive report from the U.S. Institute of Medicine (IOM) suggests that treating and preventing high blood pressure—which causes nearly half of all cases of heart failure each year in the U.S.—needs to be a higher public health priority. The report highlights some grim figures: roughly one in three American adults has high blood pressure, and, as of 2005, one in six deaths each year was caused by hypertension—a figure that represents a 25% surge since 1995. Yet, while the majority of Americans are broadly aware of the dangers of high blood pressure and the importance of routine monitoring, that awareness hasn’t carried over into efforts to treat or prevent hypertension. That’s of particular concern to public health officials, including David Fleming, chair of the IOM committee that produced the report and director of public health in Washington state’s King County. He emphasizes that, in spite of the relatively easy diagnosis and treatment for hypertension, it continues to be the number two cause of death among Americans.

The report recommends a range of tactics to better address the nation’s struggle with high blood pressure—from implementing policies that require health care providers to adhere more strictly to treatment guidelines to advocating for smaller co-payments and reduced cost of hypertension medications through health insurance companies. Of course, in addition to these approaches, an emphasis on lifestyle changes is critical, as is the need for more rigorous public health initiatives promoting such changes, the report authors stress. Public support of obese and overweight Americans to help them shed 10 lbs. each could reduce high blood pressure by 7 to 8%, and promoting physical activity among people who have settled into sedentary lifestyles could curb hypertension by as much as 6%, they emphasize. With widespread adherence, simple changes in diet—eating more veggies and lean protein and reducing salt intake—could reduce high blood pressure across the U.S. by as much as 22%, the authors suggest.

This is hardly the first public health assessment to critique Americans’ penchant for salt, which, on average, we consume at twice the rate recommended by the government. Previous studies have suggested that cutting out as little as one gram of salt per day could save 200,000 lives over the course of a decade, and larger reductions in salt intake could have even more dramatic health benefits. What’s more, curbing our sodium habit could save a lot of money too—between $10 billion to $24 billion in annual health care costs, according to some estimates.

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