State-by-state survey also found prevalence rate among men not as low as should be
MONDAY, Feb. 11 (HealthDay News) -- Uncontrolled hypertension rates are on the increase among American women, and the prevalence of this major risk factor for heart disease and stroke among American men is still not as low as it should be, a new survey shows.
"Blood pressure that is higher than optimal is among the leading two or three risks for cardiovascular disease, if not the leading one," said Majid Ezzati, an associate professor of international health at the Harvard School of Public Health and lead author of the report in the Feb. 12 issue of Circulation.
About one in five American adults has "uncontrolled high blood pressure," defined as a systolic pressure -- the higher number of the 140/90 reading -- above 140, according to the state-by-state survey. Data from two major ongoing studies, the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System, was used in the survey.
The incidence of uncontrolled high blood pressure had been declining steadily for decades into the 1990s, the researchers found. The decline has continued for American men, with the rate dropping from 19 percent to 17 percent in the early 2000s. But the incidence among American women increased from 17 percent to more than 22 percent during that same period.
There are big state-by-state differences, with the incidence of hypertension highest in southern states and the District of Columbia and lowest in Northeastern and Midwestern states such as Vermont, Connecticut, Minnesota, New Hampshire, Iowa and Colorado.
"We also found that in every state in the United States, women have higher uncontrolled hypertension prevalence rates than men do," Ezzati said in a statement. "The difference between men and women is as low as 4 percent and as high as 7 percent."
"We need to look nationally, but also especially focus on those states with the highest hypertension prevalence and emphasize interventions to do better than last decade's trends," Ezzati said.
The persistent incidence of hypertension is "principally a failure of our health-care delivery system," said Dr. Dan Jones, president of the American Heart Association. "Certainly physicians have some fault, patients have some fault, and biology plays a role. But in our current health-care system, high blood pressure is treated as part of a visit with a primary-care physician that may take only five to 15 minutes. It may be one of five or six problems that the patient has and may be the least symptomatic of those problems, so it doesn't get the attention it should."
Even when the problem is detected and hypertension medication is prescribed, "patients need to take the medicine on a regular basis, and simply fail to do so," Jones said.
Measures other than drug treatment can keep blood pressure under control, Ezzati added. "Lowering salt intake, including regulation in packaged and prepared foods, and regular testing should both be effective, as would, of course, more exercise and lower weight," he said.
"We've got to make hypertension a high priority in the treatment of patients," Jones said.
The full story on high blood pressure and its control is told by the U.S. Library of Medicine.
SOURCES: Majid Ezzati, Ph.D., associate professor, international health, Harvard School of Public Health, Boston; Dan Jones, president, American Heart Association, and dean, University of Mississippi School of Medicine, Jackson; Feb. 12, 2008, Circulation
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