High blood pressure: the toll keeps rising

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A new report from a branch of the CDC shows that the rate of hypertension (HT) in the U.S. rose slightly but significantly over the course of the years 2005 through 2009. The data were obtained from most states health departments as well as the federal health center.

It has been estimated that hypertension affects one-third of all Americans. This is so important, because HT is a silent killer: while only infrequently causing symptoms on its own, HT is a main risk factor for all the cardiovascular diseases especially heart attack and stroke as well as kidney failure. Vascular diseases are the number one cause of death in the U.S. and in the developed world overall, by a wide margin, so reducing blood pressure and the toll of HT is a major public health goal.

In 2005, national phone surveys found that self-reported HT occurred in 25.8 percent of respondents; in 2009, 28.3 percent reported having HT. While small, that increase represents well over a million adults in the population. On a somewhat more optimistic note, the fraction of people with HT who were on treatment for the condition increased as well, from 61.1 percent to 62.6 percent during that same interval. The reason the percentage is below the one-third estimated is likely some combination of under-reporting and under-detection.

A related study showed that only less than half of people with HT took their blood pressure at home, although, again, the number increased in recent years, from 43 percent in the data collection period 2005-2008, to 49 percent in 2010-2012. Since blood pressure does vary throughout the day (and night), it is recommended that patients being treated for HT (or monitored for its onset) check their own BPs at home regularly with a reliable monitoring device, many of which are available and simple to use.

The incidence of cardiovascular disease plummeted between the 1960s and the early years of this century, but levelled off in recent years. The earlier decline was due to many factors: reduced smoking, cholesterol reduction, better diagnostic techniques. Blood pressure has been tougher to control, and as is evident from these studies, only a minority of hypertensives are on therapy. Worse, less than half of Americans with HT have been diagnosed. Until we get a better handle on the diagnosis and effective treatment of high blood pressure, further progress against America s #1 killer may be slow.