After nearly 15 years on an upward trend, awareness amongst Americans about their hypertension and rates of blood pressure control are now on the decline, according to a new research study. Even with the assistance of blood pressure medications, numerous groups, including older grownups and Black grownups, are less likely than they were in earlier years to control their high blood pressure, the research study found.
The findings, released online in the Journal of the American Medical Association from scientists at the University of Alabama at Birmingham, indicate that the percentage of U.S. grownups with hypertension who were aware they had hypertension and had actually controlled high blood pressure decreased in between 2013-2014 and 2017-2018.
“Hypertension, also referred to as high blood pressure, is a major risk aspect for cardiovascular disease,” said Paul Muntner, Ph.D., teacher in the Department of Public health, UAB School of Public Health, and very first author of the research study. “More heart disease events have been credited to hypertension than any other flexible threat factor in the United States. The decline in blood pressure control rates observed in the current research study might make the longstanding efforts to fight heart disease and stroke– the leading causes of death in the United States– much more difficult.”
Almost 108 million grownups have hypertension, and according to the current research study, less than half have their blood pressure under control.
Muntner states that, due to efforts such as the National High Blood Pressure Education Program, launched by the National Heart, Lung, and Blood Institute in 1972, the awareness and control of high blood pressure gradually increased in the United States for numerous years. Previous research studies have actually revealed substantial boosts between the 1970s and 2010. The existing research study reveals those increases have actually not continued through 2017-2018.
“Our findings show a renewed need to increase high blood pressure awareness and blood pressure control in the United States,” Muntner said.
“Reversing this decrease is essential due to the fact that we do not wish to lose public health achievements constructed over previous years,” stated Lawrence Fine, M.D., chief of the Scientific Applications and Avoidance Branch at NHLBI and a research study co-author. “It is an obstacle for the scientific community to investigate the causes of this unforeseen down pattern, however establishing more efficient strategies to reverse and considerably improve high blood pressure control is crucial for the health of many Americans.”
The research study showed that antihypertensive medication usage was less typical amongst younger grownups, those who lacked medical insurance or a typical health care facility, and those who did not have a healthcare visit in the previous year. Muntner states that, while young people have a low short-term threat for cardiovascular disease, their life time threat is high.
Muntner’s team found that:
- The age-adjusted proportion of U.S. grownups with hypertension who understood they had high blood pressure increased from 70 percent in 1999-2000 to 85 percent in 2013-2014 prior to declining to 77 percent in 2017-2018.
- Amongst all U.S. adults with high blood pressure, the percentage with managed high blood pressure increased from 32 percent in 1999-2000 to 54 percent in 2013-2014 before decreasing to 44 percent in 2017-2018.
- Among U.S. grownups taking antihypertensive medication, the percentage with controlled blood pressure increased from 53 percent in 1999-2000 to 72 percent in 2013-2014 prior to decreasing to 65 percent in 2017-2018.
- Among U.S. grownups who knew they had high blood pressure, use of blood pressure-lowering medications increased from 85 percent in 1999-2000, to 89 percent in 2013-2014 and after that stayed steady at 88 percent in 2017-2018.
The team likewise reports that those between the ages of 60 and 74 and those over 75 were less most likely to have controlled high blood pressure than those 18-44 years old. Non-Hispanic Blacks were less likely to have actually managed high blood pressure than non-Hispanic whites, and those with Medicaid versus those without any medical insurance were more likely to have actually controlled blood pressure.
The research study hired 51,761 participants from data acquired from 10 cycles of the National Health and Nutrition Evaluation Study, known as NHANES. NHANES information were gathered during an at home interview and a research study see carried out at a mobile examination center.
In 2015, the United States Preventive Providers Job Force recommended yearly blood pressure screening for adults 40 years and older and among more youthful grownups at high danger for hypertension. The research study revealed that, in 2017-2018, just 58 percent of adults under 40 years of age with hypertension were aware they had high blood pressure.
Muntner states the greatest danger factor for having unchecked high blood pressure for American grownups with high blood pressure was not having a health care visit in the past year. Only 8 percent of those who had actually not had a health care check out in the previous year had actually managed high blood pressure, highlighting the requirement for individuals with high blood pressure to go to their medical professional and have their high blood pressure looked at a routine basis.
“While way of life elements are huge contributors to hypertension, awareness and appropriate treatment are key to lowering high blood pressure and keeping it in a healthy range to greatly lower the risk for heart disease and stroke,” Muntner stated. “Educating patients and providers on blood pressure objectives, adding efficient high blood pressure reducing medications when lifestyle changes aren’t enough, and reducing barriers to accomplish high medication adherence in a variety of scientific practice settings are simply a few strategies that may assist in increases in high blood pressure control rates and decrease health disparities we recognized in the present research study.”
The research study authors likewise suggest that increased insurance coverage and access to care in the 31 states and the District of Columbia that broadened Medicaid by the end of the research study period and other arrangements in the Affordable Care Act have the possible to increase the appropriate usage of antihypertensive medication amongst U.S. adults.
The study was funded by the National Heart, Lung, and Blood Institute, part of the National Institutes of Health.
Co-authors on the research study are Shakia T. Hardy, Ph.D., Emily B. Levitan, Sc.D., and Lisandro D. Colantonio, Ph.D., UAB Department of Public Health; Byron C. Jaeger, Ph.D., UAB Department of Biostatistics; Lawrence J. Fine, M.D., DrPH, Department of Cardiovascular Sciences, NHLBI, National Institutes of Health; and Gregory Wozniak, Ph.D., American Medical Association.
This news release was produced by the University of Alabama at Birmingham. The views expressed here are the author’s own.