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Uncontrolled hypertension is getting worse in the United States, according to a study



An alarming new study finds that a growing percentage of Americans suffer from uncontrolled high blood pressure, further evidence that the nation is losing ground in the fight against heart disease. Hypertension, often called the “silent killer”, is also one of the main risks of a serious COVID-19 disease.

According to the report published Wednesday in JAMA, an analysis of data from more than 18,000 patients with high blood pressure found that the percentage of uncontrolled hypertension had increased by 10% in 2017-18, compared to 2013-2014.

“These were sobering conclusions,”

; said the study’s lead author, epidemiologist Paul Muntner, research dean at the University of Alabama in Birmingham. “I was surprised. But at the same time there were indications that we saw that they were in line with this data.”

A previous study found that many patients were not prescribed blood pressure-lowering drugs according to guidelines. Many who had uncontrolled hypertension were treated with a single drug rather than a combination of drugs, which may be more effective in lowering blood pressure, Muntner said.

To take a closer look at how hypertension has been dealt with in America, Muntner and colleagues turned to the U.S. National Health and Nutrition Examination Survey (NHANES), which collected health data every two years. over the past two decades.

Researchers considered hypertension under control if:

  • the systolic measurement (the top number) was less than 140 mm Hg.
  • the diastolic measurement (the lower number) was less than 90 mm Hg.

These figures are lower than required by the most recent guidelines, according to which people should aim for 130 out of 80.

Of the 18,262 adults diagnosed with hypertension, the proportion with their blood pressure under control increased from 31.8 percent in 1999-2000 to 48.5 percent in 2007-2008 and remained stable for a number of years. In 2013-14, the percentage of controlled hypertension rose to 53.8%.

Our health in the United States is deteriorating.

Thus, the percentage of Americans with their blood pressure under control dropped dramatically to just 43.7 percent in 2017-18. When the researchers reanalyzed their data using the new 130/80 mm Hg guidelines, they found that only 19 percent of Americans with hypertension had their blood pressure under control.

One of the biggest factors related to blood pressure being checked was whether a person had seen a healthcare professional in the past year – those who had it were five times more likely to have their blood pressure checked than those who did not. .

According to the American Heart Association, more than 100 million Americans have high blood pressure. Uncontrolled hypertension is the single most significant risk factor for cardiovascular problems such as heart attacks and strokes, experts said. It is even more dangerous because when a patient has uncontrolled high blood pressure, COVID-19 is more likely to be fatal or lead to serious complications.

When Jonathan Taylor, who has high blood pressure, developed COVID-19 in March, he didn’t realize his condition put him at greater risk for serious illness.Courtesy of Jonathan Taylor

Since being diagnosed with hypertension 10 years ago, Jonathan Taylor of New York City had been maintaining his blood pressure with medication and exercise. But pandemic stress has caused some fluctuations. Taylor, a 60-year-old tennis pro, didn’t realize his condition put him at risk when he first developed COVID-19 in March.

“I’m generally someone who is healthy,” Taylor said. “I look younger than my age to others because I’ve always been fit.”

At first, his blood pressure was up and down and he felt faint and lightheaded. Then, she developed chest pain, body aches, headache and very low grade fever. After several days, he realized he was in trouble and called an ambulance. Eventually he was hospitalized for about 11 days and on oxygen.

“Boy, he did this to me by stealth,” Taylor said. “It’s really scary because, overall, my health was pretty good. And then I get sick so quickly.”

Taylor is now home, resumed his blood pressure medications and more health conscious than ever.

“It’s been a long recovery, but I’m doing pretty well,” he said.

The Centers for Disease Control and Prevention estimates that people with hypertension are three times more likely to be hospitalized if they are infected with the coronavirus, compared to those who don’t have high blood pressure. And a study published in April in JAMA found that hypertension was a major predictor of serious illness and death from COVID-19, along with diabetes and obesity.

“We know that with COVID-19, cardiovascular risk factors increase the risk of complications,” said Dr. Luke Laffin, a cardiologist at the Cleveland Clinic. “So controlling hypertension is very important.”

People need a blood pressure check at least once a year, and with many patients avoiding hospitals and doctor’s offices due to COVID-19 fears, those numbers could get worse.

“There has been a big push particularly in the past three years for people to have their blood pressure checked at home,” Laffin said. “It’s not good enough, particularly with people with hypertension, to just check their blood pressure [doctor’s] office.”

The new findings are in line with other recent studies showing the United States is losing ground to heart disease, said Dr. Matthew Muldoon, professor of medicine at the University of Pittsburgh School of Medicine and director of the UPMC Hypertension Center. .

“These new data are consistent with the reversal of our gains in fighting cardiovascular disease,” Muldoon said. “Heart disease, cardiovascular events and mortality have stopped decreasing and have started to rise. So we are losing ground. “

Dr. Erin Michos, a cardiologist at the Johns Hopkins School of Medicine, said the new data parallels an increase in obesity and diabetes in the United States.

Obesity, hypertension, and diabetes are all associated with a sedentary lifestyle and poor dietary intake, Michos said. “Our health in the United States is getting worse,” he said.


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