Mixed News on High Blood Pressure

Researchers find incidence is up, but more people have it under control

By Ed Edelson
HealthDay Reporter

TUESDAY, July 8 (HealthDayNews) -- There's bad news about high blood pressure: The incidence of this dangerous condition has edged up a bit over the past decade, to nearly a third of the country's population.

But there's also good news about high blood pressure: The percentage of Americans whose condition is known and controlled has also edged up a bit.

These findings come from a careful comparison of data from the latest NHANES (National Health and Nutrition Examination Survey), done in 1999-2000 by the National Center for Health Statistics, with numbers from the 1988-1991 NHANES.

Whether the overall news is good or bad is in the eye of the beholder, says Dr. Theodore A. Kotchen, co-author of a report on the analysis being published in the July 9 issue of the Journal of the American Medical Association.

"I tend to be an optimist and consider the greater percentage of hypertension being under control is important," says Kotchen, a professor of medicine and associate dean for clinical research at the Medical College of Wisconsin. Hypertension is the formal medical name for high blood pressure.

But the fact that 58 million Americans now have hypertension is "of some concern," Kotchen says, and it appears the national goal of having half of all cases under control by 2010 will be very hard to achieve.

"This is mixed meat," says Dr. Robert A. Phillips, chairman of the department of medicine at Lenox Hill Hospital in New York City and president of the eastern chapter of the American Society of Hypertension.

"That the number of people with hypertension has increased is bad news," he says. "The good news is despite that, the rates of control are going up slightly."

Hypertension is increasing "most notably because Americans are getting more obese, getting less exercise, and eating more processed foods," Phillips says.

Control of hypertension is a major goal because it is a significant risk factor for heart attack, stroke, and other cardiovascular diseases. It is stealthy, rarely causing symptoms. Once identified, high blood pressure usually can be reduced to safe levels with drugs.

Kotchen did the study with Dr. Ihab Hajjar, who has since moved to the University of South Carolina. The standard for high blood pressure used in NHANES was 140 over 90. Recently, the recommended readings were reduced to 130 over 80.

In the latest NHANES, 28.7 percent of participants had hypertension, an increase of 3.7 percent since the 1991 study. Of those people, 68.9 percent said they knew of their condition, about the same as in the earlier study. Of those who knew of their hypertension, 58.4 percent were being treated (an increase of 6 percent) and 53 percent of those being treated had the condition under control, up from 43.6 percent.

Overall, just 31 percent of Americans with high blood pressure have it under control, but that is a substantial increase from the 22.7 percent reported in the earlier study.

The factor most clearly associated with hypertension is simply getting old, the study found. Nearly two-thirds of those 60 and older have high blood pressure. The incidence is above average for non-Hispanic blacks (33.5 percent) and women (30 percent).

"The message here is for older people, that they really need to see a doctor and get their blood pressure checked," Phillips says. "The same is true of African-Americans."

More information

You can learn about hypertension and what to do about it from the American Heart Association or the American Society of Hypertension.

SOURCES: Theodore A. Kotchen, M.D., professor, medicine, and associate dean, clinical research, Medical College of Wisconsin, Milwaukee; Robert A. Phillips, M.D., chairman, department of medicine, Lenox Hill Hospital, New York; July 9, 2003, Journal of the American Medical Association

High Blood Pressure Increasing

(Ivanhoe Newswire) -- New research shows the number of Americans diagnosed with hypertension has increased in recent years.

Nearly one-third of the adult population, or 58 million people, in the United States have hypertension. Hypertension is a major risk factor for cardiovascular disease and even death.

Researchers from the University of South Carolina and the Medical College of Wisconsin studied the most recent National Health and Nutrition Examination Survey to examine hypertension trends. In their study, hypertension was defined as having a blood pressure reading of 140/90 mm Hg or greater or being on antihypertensive drugs. They found the number of reported hypertension cases increased by nearly 4 percent between 1991 and 2000. Prior to 1991, however, hypertension prevalence had decreased over the last three decades.

Symptoms of hypertension are often overlooked, causing many cases to go undiagnosed. Between 1999 and 2000, nearly 30 percent of individuals with hypertension were unaware of their illness. In more than 60 percent of these cases, the patients' hypertension was not under control at the time their blood pressure was measured.

Authors of the study say, overall, hypertension control rates have improved since 1988, but they are still unacceptably low. "If the increase in hypertension control rates remains at the current pace, the 50 percent target for hypertension control by 2010 will not be met," they write. Programs targeting awareness and treatment options are underway to improve the current statistics.

SOURCE: Journal of the American Medical Association, 2003;290:199-206

This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/.

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