Blood pressure study reports improvements

DALLAS – Americans, especially those 60 and older, are doing a better job of keeping their blood pressure under control, a new analysis says, a sign that people are getting the message about the risks of the condition. But the study also found that the prevalence of high blood pressure was about the same.

“I think it gives more evidence that the modest improvement in blood pressure control rates are continuing,” said Dr. Daniel Jones, the American Heart Association’s president-elect. “The good news is they’re better than 10 to 15 years ago. The bad news is they’re not nearly as good as they need to be.”

About 37 percent of Americans with high blood pressure had it under control in 2003-04, compared with about 29 percent just four years earlier, the research showed.

High blood pressure affects more than 65 million adults in the United States. Not getting it under control can increase the risk for heart attack, stroke, heart failure and kidney failure.

Experts say the improvement in controlling blood pressure is likely due to aggressive efforts at educating the public.

“We’re constantly talking about the importance of it, and I believe that message is sinking in,” said Jones, dean of the school of medicine at the University of Mississippi Medical Center in Jackson, Miss.

Also, doctors note it has become more accepted in the last few years to use multiple medications to attack the problem. “It’s been a gradual change toward combination therapy,” said Dr. Shawna D. Nesbitt, an associate professor of internal medicine who specializes in hypertension at the University of Texas Southwestern Medical Center.

Doctors say that since high blood pressure often does not have accompanying symptoms, it can be a challenge to get patients to understand the importance of taking several drugs to control it.

Despite the improved control rate, the proportion of Americans who had high blood pressure stayed roughly the same – about 27 percent in 1999-2000 and about 29 percent in 2003-04.

Still, an improvement in control rates should have a positive effect on stroke and heart attack rates, said the study’s author, Bernard Cheung, an associate professor at the University Department of Medicine of Hong Kong.

For the study, published online Monday in the American Heart Association journal Hypertension, high blood pressure was defined as 140/90 or higher, or by someone taking blood pressure-lowering medication. The new information came from a comparison of data from 14,653 adults in the National Health and Nutrition Examination Survey.

In those older than 60, control rates improved from 26 percent in the time period studied to 37 percent. Awareness in that age group improved from 71 percent to 81 percent.

Researchers found that besides older people, overweight people also had better rates of control and awareness, probably because of growing attention in this country on the health risks of obesity.

Researchers note that in 2003-04, about a third of all patients with high blood pressure remained unaware of their condition and the treatment rate was still only 54 percent, meaning about half of high blood pressure patients weren’t being treated.

“Things are getting better, but there’s still a long way to go,” said Dr. Karol Watson, assistant professor of medicine and cardiology at the David Geffen School of Medicine at the University of California, Los Angeles.