Nearly 1 in 3 Americans suffers from high blood pressure and more than half don’t have it under control, says a recent study from the Centers for Disease Control and Prevention (CDC). According to the report, most people with uncontrolled high blood pressure have health insurance and had actually seen a doctor at least twice in the previous year, yet their condition remained unmanaged.
High blood pressure is defined as a reading of 140/90 mm Hg or higher (if either the top or bottom number meets the threshold, blood pressure is considered high). Having high blood pressure is a major risk factor for heart disease and stroke: hypertensive people are four times more likely to die from a stroke and three times more likely to die from heart disease than people with normal pressure, according to CDC director Dr. Thomas Frieden. Together, those two conditions cause nearly 1,000 deaths a day in the U.S. and account for $131 billion in yearly health-care costs. “[High blood pressure] is public health enemy No. 2, second to tobacco,” said Frieden in a teleconference on Tuesday.
For the new report, researchers looked at 2003-10 data from the National Health and Nutrition Examination Survey (NHANES) to examine high blood pressure awareness and treatment among adults with uncontrolled conditions. More than 20,000 adult participants answered survey questions and received a physical exam.
The data suggest that some 67 million Americans have high blood pressure, and nearly 36 million of them don’t have their condition under control. Among those, about 14 million don’t know they’re hypertensive, nearly 6 million are aware but not receiving treatment, and 16 million know they have high blood pressure and are receiving medication for it but still don’t have their pressure under control.
About 26 million people with uncontrolled hypertension saw their doctor twice in the previous year. “We have to roll up our sleeves and make high blood pressure control a priority every day, with every patient at every doctor’s visit,” said Frieden. “We can use the whole health-care team. We know that when pharmacists, nurse practitioners, allied health workers, office staff are all involved in care, we can see rapid and dramatic improvements in blood pressure control.”
The CDC says that current medications to reduce blood pressure work well, and that with collaboration between patients and health-care providers, the condition can be quickly remedied. Here are the CDC’s recommendations:
- Patients should take their prescribed medications and work with their doctors to lead a healthy lifestyle, including eating a low-sodium, heart-healthy diet rich in fruits and vegetables, getting regular exercise, and losing excess weight
- Health-care providers should monitor patients’ blood pressure and prescribe once-a-day medications with clear instructions
- Health systems should use electronic health records to better track patients, and encourage the use of 90-day refills and consider having low or no co-pays
“Five years from now, there should be at least 10 million fewer Americans with blood pressure out of control,” said Frieden.
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To keep their blood pressure down, individual patients should eat better, increase physical activity and maintain a healthy weight, but on a population level, said Freiden, the food industry must also voluntarily and steadily reduce the amount of sodium in packaged foods, which can potentially help reduce overall blood pressure levels among Americans.
Major progress will likely be made through more effective treatment, however. “We know that many things contribute to high blood pressure and a lot can be done to reduce it in society as a whole. But today in this country, more than two-thirds of people over 65 have high blood pressure and realistically, for the foreseeable future, one of the most important things we will be able to do is to improve treatment,” said Friedman.