Considering how many people eat too much and exercise too little, it's not surprising that nearly 67 million Americans have
What gives? The
Yes, uncontrolled hypertension is highest among people who do not have doctors or health insurance, or are poor or uneducated.
"But most people who have it go to doctors and have insurance," said Amy Valderrama, lead author of the study and epidemiologist with the CDC's Division for
Although seniors are more likely to have hypertension, the largest group with uncontrolled hypertension is ages 18 to 24. Seniors are more likely to take their medication.
Hypertension is blood pressure of 140/90 or higher. For every increase of 20 of the systolic (first) number or 10 of the diastolic (second) number, the risk of heart disease and stroke double, said the CDC report. That is starting from a base of 115/75.
Left unchecked, hypertension contributes to heart disease and strokes, which the CDC said are the first and fourth leading causes of death. This adds $131 billion to our collective health-care costs each year.
"Hypertension is known as the silent killer because you may not have any symptoms," said Dr. Steven Fox, internist at Advocate Illinois Masonic Medical Center in Chicago. "You don't know you have it, so you necessarily don't go to the doctor."
"Men are notorious for not going," said Samantha Mok, cardiology social worker with
Both genders are guilty of denial, added Mok. "People just want to ignore it," she said.
Even though side effects of hypertension medications are uncommon, said Fox, they worry many patients. They include dry cough and fatigue, but the one that scares off the most patients is impotence, he said.
"If that happens, the patient may just quit taking the medication and not talk to his doctor about it," said Fox. "But if he does tell us, we may be able to try something else. Or, we try a combination of medications."
Others just neglect their prescriptions because they see no gain, said Fox. "With something like
Noncompliance is not for lack of availability. Most pharmacies offer free blood-pressure checks. Big-box retailers sell popular hypertension medications at discounted prices.
Meanwhile, too many Americans continue to eat high-fat and high-salt foods, lead sedentary lives and smoke cigarettes, which all contribute to hypertension, said Valderrama. Competing with
The CDC report said doctors, pharmacists and other health care workers need to work with the patients in a team-based approach to combat hypertension. But pharmacists have little contact with patients today and doctor visits are shorter.
So, what is the solution? "Doctors need to do a better job counseling patients about their lifestyles choices, then follow-up," said Fox. "This is a public health problem, with obesity,
Valderrama points to groups that are increasing public awareness of hypertension, such as Million Hearts, aimed at the public, and Team Up. Pressure Down, which targets pharmacists.