Hypertension, the silent killer, needs more attention in young adults

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A new study shows that high blood pressure (HBP) is being inadequately treated among those with primary care physicians, and the level of control is worst among those younger adults with the risky condition.

Hypertension (HBP) is very common in adults, yet is tragically underdiagnosed and undertreated, contributing to the toll of the #1 killer in America: cardiovascular disease (CVD). While in and of itself HBP causes few or no symptoms, it is a major risk factor for heart disease, stroke, and kidney disease. Since it is asymptomatic (silent), its detection and treatment depend on routine BP checks by a healthcare provider. In recent years such BP checks have become available in many pharmacies as well as in clinics and doctors offices.

When HBP is diagnosed, initial treatment might include reducing salt intake and weight loss. If those non-pharmaceutical interventions work, they must be maintained.

However, the majority of cases of HBP require drug treatment. That s where the devilish details come into play. While millions of Americans have HBP, only a minority have had it diagnosed. And among those, only a minority are receiving treatment sufficient to lower BP to a non-threatening level.

The current study, which sought to determine the efficacy of HBP treatment among newly-diagnosed patients and to compare this between various age cohorts, was led by Dr. Heather Johnson at the University of Wisconsin, Madison. They evaluated patients attending the center s primary care clinics between 2008 and 2011, and focused on the 10,000 patients with newly-diagnosed HBP. They found that among the youngest adult group (ages 18-39, about 2,600 of the total group), only one-third were receiving effective treatment of HBP to reduce or remove CVD risk. This compared with 44 percent of those aged 40-59, and 56 percent among those over 60.

Among young adults, in particular, predictors of not starting a drug or achieving blood pressure control included age under 30, male, milder hypertension, and white race. A possible reason for that last factor "is that primary care providers may be responding to the known increased risk of comorbidities with hypertension among minorities, especially African Americans," the authors wrote.

ACSH s Dr. Gil Ross had this comment: Considering the importance of keeping HBP under control, this is a disturbing finding, since it has been shown that HBP among younger adults is just as concerning as a risk factor as it is among seniors. Doctors need to be better informed about treating the condition aggessively to prevent heartache figuratively and literally a few years down the road. Another problem not highlighted in this study is that several HBP drugs, among the many such available, have side effects such as fatigue and sexual impacts, that cause patients to become non-compliant. This is another issue the conscientious physician should watch for, and deal with.