According to the American Heart Association, high blood pressure (hypertension) affects nearly one in three U.S. adults. And while a study published last year in the Journal of the American Medical Association found that half of Americans had their blood pressure under control in 2008, many doctors are still coming up short when it comes to finding treatment for patients whose hypertension has not been adequately controlled on their current regimen.
A new study, also published in JAMA, investigated this problem more thoroughly by using data from a national survey of all doctor visits to private practitioners between 2005 and 2009. Researchers from the University of California, San Francisco, found that during the study period, 662 million doctor visits were made by adults already diagnosed with hypertension and on no more than eight medications. Of these, nearly 42 percent had an in-office blood pressure measurement indicating at least mild hypertension (140/90 mm Hg), yet prescriptions for new hypertension drugs were given to less than 20 percent of such patients a figure that did not improve between 2005 and 2009.
If patients identified high blood pressure as a reason for their doctor visit, the rate of new prescriptions was higher but still remained below 50 percent. What s to be done? Ultimately, patients may need to be more vocal. The study authors concluded that those with hypertension should be more proactive about discussing their condition with their doctors in order to receive better treatment. Missed opportunities for new blood pressure medication prescription are common in the United States, the researchers say.
I find it bizarre to blame the patient for the clear failure of doctors to adequately address one of our nation s most significant, albeit silent, killers, says ACSH's Dr. Gilbert Ross. Sure, patients should be encouraged to be more assertive and proactive about their health, but it s the doctor who must decide to aggressively control blood pressure, and the one-in-five success rate for such control is simply unacceptable.