"With younger individuals, men and Hispanics, the emphasis needs to be placed on raising awareness and getting treatment," he said. "For older individuals, African-Americans and women, while there are more people on treatment and awareness is high, the percentage under control is lower than average."
Egan said he did the study because he has been working on hypertension awareness and control with 200 community-based medical practices in the southeastern United States, where high blood pressure is more common. "I thought we should have a good idea of what is happening nationally," he said.
The survey found a slightly lower rate of hypertension control among blacks than the general population, but the difference is small enough so that it might be a matter of chance, Egan said. A recent study found an overall reduction of stroke incidence in the United States, but not in blacks.
Worries about high blood pressure have led to a proposal of a national program aimed at reducing the salt content of American foods, since high blood levels of sodium are known to raise blood pressure.
Reducing sodium intake is a good idea, Egan said, "but my own preference is to focus on diet quality. Eating more fruits and vegetables and whole foods reduces sodium intake."
Preventive measures such as better diet, more physical activity and weight reduction are needed to bring hypertension under control, said Dr. Aram V. Chobanian, former dean of the Boston University Medical Center and president emeritus of Boston University, who wrote an accompanying editorial.
"There is very little evidence that lifestyle has improved in the United States, but in the long run that is where the greatest benefit is going to be," Chobanian said. "Otherwise, as the population ages and the obesity epidemic increases, the prevalence of hypertension will increase."
Changing the American lifestyle won't be easy, he said. "It has t
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