Although approximately three-quarters of US adults with coronary heart disease, stroke, diabetes, or other conditions that increase their risk of developing cardiovascular disease suffer from high blood pressure (hypertension), only about 33% to 50% of them ever reach their blood pressure targets, according to an article published in Archives of Internal Medicine (JAMA/Archives), December 10/24 issue.
The authors explain that controlling blood pressure is not only an American problem, it’s an international one. The researchers write “Recent estimates indicate little change in the prevalence of hypertension, and, although there seem to be some recent improvements in treatment and control rates, hypertension in many persons remains inadequately controlled.”
Nathan D. Wong, Ph.D., University of California, Irvine, and team looked at information taken from adults who had participated in the National Health and Nutrition Examination Survey, carried out by the CDC (Centers for Disease Control and Prevention). In the year 2003/2004 4,646 participants provided information on where they lived and their socioeconomic status – they also underwent psychological and laboratory testing, as well as having their blood pressure measurements taken.
34.4% of them (1,671) had hypertension. Hypertension meant their systolic* blood pressure was 140 milligrams of mercury or more, 130 milligrams of mercury for people with chronic kidney disease or diabetes, or a diastolic* blood pressure of 90 milligrams of mercury or more, 80 milligrams of mercury for those with diabetes or chronic kidney disease. The researchers also found that hypertension was more common among older people and afro-Americans.
* Systolic refers to the higher number. Diastolic refers to the lower number.
68.5% of those with high blood pressure were being treated for it, while only 52.9% of those being treated had it under control.
Hypertension was found among people with cardiovascular diseases and related conditions.
The following proportions suffered from hypertension:
— People with diabetes, 76.8%
— People with chronic kidney disease, 81.8%
— People who had suffered a stroke, 69.5%
— People with congestive heart failure, 71.4%
— People with periphery artery disease, 73.7%
— People with coronary artery disease, 73%
— People with at least two of the above-mentioned diseases, 76.9%
Of the people listed above, at least 75% were being treated for high blood pressure. However, just one third of those being treated managed to reach their blood pressure goal levels of 140/90 milligrams of (130/80 for those with diabetes or chronic kidney disease). The researchers noticed that only 34.9% of stroke patients, 48.8% of heart failure patients, 46.7% of peripheral arterial disease patients, and 50.3% of those with coronary artery disease managed to reach their blood pressure goals.
Of the diabetes and chronic diseases patients who had lower goals, just 35% and 23% respectively were controlled for their blood pressure. The people who were uncontrolled had a systolic pressure 20 points higher (average) than their targets.
The authors wrote “Poor control rates of systolic hypertension remain a principal problem that further compromises the already high cardiovascular disease risk (in these individuals). Moreover, given recently released recommendations to reduce the blood pressure goal to less than 130/80 milligrams of mercury for persons with coronary artery disease and other high-risk conditions, our hypertension control rates would be even lower and a greater distance from the goal for these persons if the new criteria are applied.”
“Inadequate Control of Hypertension in US Adults with Cardiovascular Disease Comorbidities in 2003-2004”
Nathan D. Wong, PhD; Victor A. Lopez, BS; Gilbert L’Italien, PhD; Roland Chen, MD; Sue Ellen J. Kline, PhD; Stanley S. Franklin, MD
Arch Intern Med. 2007;167(22):2431-2436.
Written by – Christian Nordqvist