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Consciousness of Blood Pressure Is Rising as Details About Possible Remedies Continue to Evolve

Authors: Linda Brookes, MScFaculty and Disclosures



More good news this month: The US Centers for Disease Control and Prevention reports that most Americans with high blood pressure know it and are trying to control it. They need to do more, however, because another report, from a number of national health organizations, points to evidence of a "serious global epidemic" of hypertension, affecting 1 billion adults and with consequences more severe than that of any highly publicized infectious disease, if rational global prevention measures are not adopted. Furthermore, a link between high blood pressure and sudden cardiac death in heart failure patients has now been reported. This is followed by more controversy about angiotensin receptor blockers, perhaps controversial claims for statins, and updates for several dietary items. Finally, what about an implantable blood pressure monitor?

Most Americans Trying to Control Their Blood Pressure, National Statistics Indicate

According to the latest report from the US Centers for Disease Control and Prevention (CDC) published in the May 4 issue of MMWR Morbidity and Mortality Weekly Report,[1] most people with hypertension in the United States take some action to control their blood pressure. However, there is still room for improvement, and most hypertensive individuals could make more of an effort to control their blood pressure, including changing their diet, exercising, and taking prescribed medication, according to lead author of the report, epidemiologist Clark Denny, PhD.

Dr. Denny and his colleagues calculated the prevalence of self-reported hypertension and the actions taken to control it, using data from the Behavioral Risk Factor Surveillance System (BRFSS), an ongoing, nationwide, random-digit-dialed telephone survey used to determine the prevalence among adults aged ≥ 18 years of behaviors and practices related to the leading causes of death in the United States. These include cigarette smoking, seat belt use, blood cholesterol screening, high blood pressure control, physical activity, weight control, alcohol use, and drinking and driving. The BRFSS, which has been tracking these conditions and behaviors since 1984, is coordinated by the National Center for Chronic Disease Prevention and Health Promotion of the CDC.

Data were provided by 20 states in response to an optional module of the survey carried out in 2005. A total of 24,447 out of 101,574 respondents said that they had been told on 2 or more visits to a doctor or other health professional that they had high blood pressure. The age-adjusted prevalence of self-reported hypertension was 19.4% for the 20 states combined. Hypertension prevalence increased with age: 2.4% in people aged 18-24 years, 8.3% at age 25-44 years, 27.7% at age 45-64 years, and 44.4% at age ≥ 65 years. Hypertension prevalence was also higher in non-Hispanic blacks (27.2%) than in non-Hispanic whites (18.6%), Hispanics (18.0%), or Asians (14.7%). Among the 20 states, hypertension tended to be highest in southern states, with Mississippi (25.5%), West Virginia (23.5%), Alabama (23.2%), Louisiana (22.1%), and Arkansas (21.9%) having the highest age-adjusted prevalence.

In response to questions about 5 specific actions they could take to control their blood pressure, 98.1% of the respondents with hypertension answered that they had taken 1 or more of the following actions, and most reported taking all the actions:

  • 70.9% changed their eating habits;

  • 79.5% reduced their use of salt or did not use salt;

  • 79.2% reduced their consumption of alcohol or did not drink alcohol;

  • 68.6% exercised; and

  • 73.4% took antihypertensive medication.

Women were more likely to report changing eating habits and reducing their consumption of alcohol or not drinking alcohol. Reducing use of salt or not using salt and taking antihypertensive medication increased with age. A higher proportion of non-Hispanic blacks (90.0%) compared with other racial/ethnic groups reported reducing use of salt or not using salt.

An editorial note accompanying the report cautions that the median response rate for the 20 states was only 51.0% and that the combined results cannot be generalized to the country as a whole. However, the report says that although nearly all adults with hypertension are doing something to control their blood pressure, it is clear that some can take additional action. For example, 70% of the respondents said that they exercised, which means that the remaining 30% could start doing the same, the authors of the report point out.

The report was released to coincide with National High Blood Pressure Month (May) in the United States. The CDC aims to increase identification, treatment, and control of high blood pressure and clarify the actions needed to control it through its Heart Disease and Stroke Prevention Program, which funds state health departments to support heart disease prevention activities, and in partnership with other government departments and national medical groups through its broader campaign, A Public Health Action Plan to Prevent Heart Disease and Stroke.

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