The US seems to be losing ground in controlling high blood pressure


After years of improvement, control of high blood pressure in the U.S. fell regardless of age, race, or ethnicity, according to new research.

Previous studies found Americans with discharge they were improving state management during the early years of the 21st century before rates balanced from 2009 to 2014.

The new study, published Monday in the journal American Heart Association Hypertension, expanded nationwide survey data from more than 4,000 adults from 2015 to 2018. The researchers compared high blood pressure control, awareness, treatment, and treatment effectiveness with nearly 6,000 adults surveyed over the previous six years.

They found that the control rate, which reduced blood pressure to a specific number, had dropped by 7.5%.

“This is a very sharp decline,” said the study’s lead author, Dr. Brent Egan. “We lost about ten years of progress in four years.”

The researchers, who hoped to find disparities in the drop in blood pressure control by age, race or ethnicity, found none. “We were amazed at the sheer breadth of the decline (in blood pressure control),” said Egan, vice president of cardiovascular health at the American Medical Association.

But control rates weren’t the only ones that fell. Awareness of having high blood pressure fell by 3.4% and he was treated by 4.6%. Among the treaties, 6% less had the disease under control.

The study also found an increase in people receiving a single drug despite an increase in obesity and diabetes, two conditions that require “more intensive treatment (medication) to control hypertension,” according to the study. study.

Yes they are reluctant to prescribe multiple medications, and if patients are hesitant to take them, a possible answer is “a combination in which you have two or three blood pressure medications in a single pill,” Egan said.

There were low rates of awareness, treatment, and treatment effectiveness, even though people had the same access. , showed the findings. This suggests a worsening of the quality of care for the diagnosis and control of high blood pressure, Egan said, which could be the result of primary care physicians being overwhelmed by patients with multiple chronic conditions such as diabetes and obesity.

“It’s extremely difficult to manage all of these conditions in a 15-minute visit,” he said. “We need new approaches. We need effective and efficient improvement programs, more self-control and better public health campaigns to attract patients and make them understand their hypertension.”

The current guidelines of the AHA and the American College of Cardiology for the treatment of high blood pressure, updated in 2017, define stage 1 high blood pressure as 130 and higher for systolic blood pressure (the number upper) or 80 and higher for diastolic (lower number). Since the study was based on older data, it defined high blood pressure as 140/90 or higher.

The study was also limited by its relatively small size and design, Egan said. “We don’t follow a group of individuals. We just take snapshots in time.”

Dr. Gbenga Ogedegbe, who did not participate in the research, called it an important study that shows there are still many questions to answer about control.

In particular, he said more research is needed on the role of obesity in controlling hypertension, especially among blacks in the United States because AHA statistics show that more than half have .

“Given the role of obesity as a major risk factor for uncontrolled hypertension, we need to focus our efforts on how to do a better job with it,” said Ogedegbe, a population health professor and director. from the NYU Langone Health Institute of Health Equity Excellence in New York City.

He stressed the importance of addressing the upward factors that contribute to the increase in obesity in communities of color, such as the need for more parks and better access to areas that allow people to be physically active.

“If we know that lifestyle behaviors are important,” Ogedegbe said, “what do we do to encourage healthy behaviors like exercise?”

Americans continue to struggle to control high blood pressure: 11% fewer adults have it under control

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