"This is a problem that spans much of preventive medicine," Stafford said. "The treatment itself doesn't make patients feel better. If somebody has asthma, they know that if they stop taking medication, they're going to start wheezing. With blood pressure medicines, patients don't feel any different."
Without this noticeable change, many patients stop following the doctor's orders or fail to return for follow-up care.
"We know many patients don't take the medications they were prescribed for the doses that were prescribed nor for the duration that was prescribed," lead author Dr. Jun Ma, an associate staff scientist at the Palo Alto Medical Foundation Research Institute, said in a prepared statement.
Increasing routine blood pressure screenings, even in specialists' offices, could be the first step to improving care, Stafford said.
"Many physicians in specialized practice appear to feel they don't need to measure blood pressure," he said. The thinking goes, "'I'm a dermatologist, so I don't need to screen for high blood pressure.' But because there's a high likelihood of high blood pressure getting missed, we need to take advantage of all opportunities for screening."
Once a doctor diagnoses someone with high blood pressure, the physician must clearly explain the necessary treatments and strongly encourage lifestyle changes.
"Physicians may need to tell patients that it's likely to take two or more medications to get blood pressure under control," Stafford said. "They also need to use a comprehensive strategy to attack high blood pressure that includes recommended changes in lifestyle: weight loss, reduction in sodium, a plant-based diet, increases in physical activity. Both patients and physicians need to take advantage of all available strategies."
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