Most Americans Don't Have High Blood Pressure Under Control

The condition raises the risk of heart attack and stroke, study authors note

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HealthDay Reporter

THURSDAY, May 3, 2007 (HealthDay News) -- Although most Americans with high blood pressure are taking steps to combat the potentially deadly condition, only 30 percent have it under control, a new federal study found.

That means the 70 percent of adults with uncontrolled high blood pressure, also known as hypertension, must do more to bring those levels down, including changing their diet, exercising and sticking to their drug regimens.

If they don't, they face an increased risk of heart disease and stroke, according to the study authors from the U.S. Centers for Disease Control and Prevention.

"Most people with high blood pressure (98.1 percent) are doing something to lower it," said lead author Clark Denny, an epidemiologist with the CDC. "But there is still room for improvement.

"Almost everyone with high blood pressure can have it controlled through medication and lifestyle change," he added.

While the number of people who are doing things to control their blood pressure is increasing, so is the number of people with high blood pressure, Denny said. "It's bad news that the number of people with high blood pressure is going up," he said. "That may be due to changes in diet, people's weight going up and, in part, to aging."

For the study, Denny's team collected data on 101,574 people who participated in the Behavioral Risk Factor Surveillance System. The researchers found that in 2005, of the 24,447 people from 20 states who said they had high blood pressure, 98.1 percent were doing at least one thing to lower or control it.

For example, 70.9 percent said they had changed their eating habits; 79.5 percent had reduced their use of salt or did not use salt; 79.2 percent had reduced the amount of alcohol they drank or did not drink; 68.6 percent exercised, and 73.4 percent took medication to lower their blood pressure.

"But that means that about 30 percent in each category need to do more," Denny said.

Denny thinks that people need to be educated about the dangers of high blood pressure and what they can do to lower it. Also, "there has to be a partnership between doctors and patients to help people control their blood pressure," he said.

The findings are published in the May 4 issue of the CDC's Morbidity and Mortality Weekly Report (MMWR).

An editorial note in the MMWR supports a broad-based approach to controlling blood pressure.

"A comprehensive approach to lifestyle modification that targets diet, salt intake, alcohol intake, and exercise can help to control high blood pressure," the CDC authors wrote. "The Dietary Approaches to Stop Hypertension diet, which is low in saturated and total fat and emphasizes fruits, vegetables, and low-fat dairy products, has assisted with reducing blood pressure. High blood pressure control requires maintaining lifestyle changes and taking prescribed medications.

"Self-management can increase overall high blood pressure control, and improvements in counseling from health-care providers, patient education, and clinician-patient partnerships could further encourage adults with high blood pressure to take action," they concluded.

Dr. George Bakris, a professor of preventive medicine and internal medicine at Rush University Medical Center in Chicago, thinks that most people with high blood pressure need a combination of medication and lifestyle changes.

"Lifestyle modification is critically important," said Bakris. "But if you have a family history of hypertension, lifestyle modification alone is not going to control your blood pressure -- you are going to need medications."

Conversely, medication isn't the sole answer either, Bakris said. "If you are not exercising, you should be exercising. You should be reducing salt consumption to no more than 4 grams a day. And you shouldn't drink more than two glasses of wine a day.

"These are the commonsense things people have to think about," Bakris added. "A lot of people take medicines and think that is enough and the lifestyle changes can be avoided. But that's not true. People who try to go that route never get really good blood pressure control."

More information

A guide to lowering high blood pressure is offered by the U.S. National Heart, Lung, and Blood Institute.

SOURCES: Clark Denny, Ph.D., epidemiologist, U.S. Centers for Disease Control and Prevention, Atlanta; George Bakris, M.D., professor of preventive medicine and internal medicine, Rush University Medical Center, Chicago; May 4, 2007, Morbidity and Mortality Weekly Report

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