Mixed News on High Blood Pressure

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

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HealthDay Reporter

(HealthDay is the new name for HealthScoutNews.)

TUESDAY, July 8, 2003 (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

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