Higher Percentage of American Adults With Hypertension Are Controlling Their Condition, Says Study

Progress Reflects Awareness, Treatment Improvements -- Not Lifestyle Changes

June 21, 2010 05:15 pm News Staff

The United States has achieved the Healthy People 2010(www.cdc.gov) objective of adequately controlling blood pressure in 50 percent of Americans with hypertension. That figure represents an improvement from 10 percent in 1980 and 31 percent just 10 years ago.

[Stock photo of health care professional checking patient's blood pressure ]

The United States has reached the Healthy People 2010 goal of controlling blood pressure in 50 percent of Americans with hypertension, but the nation has not progressed toward the Healthy People goal of reducing the prevalence of hypertension to 16 percent.

Not all of the news is good, however.

The figures were published in a study(jama.ama-assn.org) in the May 26 issue of JAMA: The Journal of the American Medical Association. The study suggests that the increased proportion of patients with well-controlled hypertension (i.e., systolic blood pressure less than 140 mm Hg and diastolic blood pressure less than 90 mm Hg) likely did not stem from more patients adopting healthier lifestyles.

Rather, the increased percentage of patients with hypertension who are adequately controlling their blood pressure probably reflects improvements in awareness levels and treatment protocols, as well as growth in the proportion of patients who are receiving appropriate treatment, according to the study.

Researchers say the fact that obesity increased during the period covered by the study (1988-2008) indicates that it is unlikely overall increases in adequate control of hypertension can be attributed to positive lifestyle modifications.

Hypertension by the Numbers

32 -- percentage of noninstitutionalized American adults with hypertension in 2003-06, or 74.5 million people
53 -- percentage of U.S. nursing home residents with hypertension in 2004, or about 790,000 people
326,000 -- number of people for whom hypertension was a primary or contributing cause of death in 2006
40.5 million -- number of ambulatory care visits in 2006 with hypertension as the primary diagnosis
$76.6 billion -- estimated direct and indirect costs of high blood pressure this year in the United States

Sources: CDC FastStats(www.cdc.gov) and CDC Feature: High Blood Pressure(www.cdc.gov)

The study's authors point out that obesity is a characteristic of individuals with treatment-resistant hypertension. Yet, despite challenges involved in controlling blood pressure in patients who are obese, they note, from 1999-2004, control improved in all obese patients but not in all nonobese patients with hypertension.

Therefore, they suggest that more patients -- especially patients who are obese -- are receiving more medications to control their blood pressure.

Healthy People 2010 called for reducing the prevalence of hypertension from 28 percent in 1994 to 16 percent by 2010. According to the study, however, the prevalence of hypertension actually increased between the National Health and Nutrition Examination Survey conducted in 1988-94 and the survey conducted in 1999-2000. Although the prevalence did not change between the 1999-2000 survey and that conducted in 2007-08, it "remains much higher than the national goal," says the study.

According to the study's authors, adults ages 18-39 were more likely than those ages 60 and older to achieve adequate control of high blood pressure with treatment, and they suggest that efforts to improve blood pressure in younger adults should focus on raising awareness and linking these patients to primary care services.

Similarly, because hypertension awareness and treatment rates were lower among Hispanics than among blacks or whites, the study suggests that efforts to improve blood pressure control in Hispanics should focus on screening and referral to patient-centered medical homes.