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U.S. Ignores Warnings on Hypertension

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Doctors have been warning patients for decades about the hazards of high blood pressure --- to the point of it becoming a daily mantra.

Americans aren't listening. Or they're choosing not to heed advice to keep their blood pressure in check, a new medical study has determined.

The data, published today in the Journal of the American Medical Association, shows that the percentage of Americans suffering from hypertension has increased to nearly 29 percent after holding at or below 25 percent for the last 30 years.

The conclusions are based on data collected from the 1999-2000 National Health and Nutrition Examination Survey, which is taken every few years to check on America's health.

If the increase sounds slight, it still means nearly one-third of the U.S. adult population --- about 58 million people, researchers said --- have high blood pressure, a major risk factor in heart attack, stroke and cardiovascular disease.

America's widening waistlines and sedentary lifestyles play a role in the trend, experts said. And Southerners, who have traditionally led the nation in obesity and stroke, should pay particular heed.

"While we weren't able to specify the exact reasons, the increase in body mass index over the same period could certainly be playing a role, in addition to the fact that the population is aging," said Dr. Ihab Hajjar, an assistant professor with the University of South Carolina School of Medicine. Blacks, elderly at risk

African-Americans, the elderly, obese people and heavy drinkers are most likely to be affected by hypertension.

Known as the "silent killer," high blood pressure stresses the heart, blood vessels and other organs because the body has to work harder to pump blood. People often feel no symptoms, but the longer hypertension goes untreated, the greater the damage and chances of death, doctors say.

Hajjar, who specializes in geriatric medicine, said he is particularly concerned about high blood pressure among senior citizens. The condition is more difficult to control among the elderly because they often need to take multiple medications.

Dr. William Cooper, a cardiothoracic surgeon at Emory Healthcare and an assistant professor at the Emory School of Medicine, said he is not surprised by the rise in high blood pressure rates.

"Patients don't see themselves as statistics so they don't relate to what we tell them," Cooper said. "They think, 'That's not me. That won't happen to me.' "

He estimates about 90 percent of his African-American patients and 70 percent of his white patients have hypertension.

"I have high blood pressure," he said. "Sometimes, due to the nature of my job, I get off my regular jogging program. You really have to be vigilant about it. For many patients, once they realize that this should have been their No. 1 priority, it's too late. Why does it take having a stroke to pay attention?" Sufferers unaware

In reviewing the 1999-2000 data, researchers found that nearly 29 percent of the study participants had hypertension, an increase of 3.7 percentage points --- or about 8 million people --- from 1988-1991. Non-Hispanic blacks showed the highest rate, 33 percent. The prevalence among people over 60 was 65 percent.

Many with high blood pressure either were unaware of their condition or were not being treated adequately, researchers said. Previous studies have found that as many as 50 percent of patients use hypertension drugs improperly or stop taking them altogether. > ON THE WEB: National Heart, Lung, and Blood Institute: American Heart Association:

Copyright 2003 The Atlanta Journal-Constitution

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