AHA Study Shows US Lagging in Controlling High Blood Pressure

In an analysis of hypertension control in the US from 2009 to 2018, researchers found that rates of blood pressure control in the US are falling rapidly, pointing to a larger population health issue, according to a study published in the American Heart Association’s Hypertension.

Using health survey data from more than 4,000 US adults between 2015 and 2018, researchers found that the rate of control had fallen by 7.5 percent. Blood pressure control is defined as getting one’s blood pressure back down to a healthy level. The study also compared the recent data with survey data from 6,000 adults collected between 2009 and 2015.

"That's a very strong decline. We lost about 10 years of progress in four years," said Brent Egan, MD,  the study's lead author, in an AHA news article.

In addition to declining control rates, high blood pressure awareness fell by 3.4 percent, and the amount of people being treated for high blood pressure fell by 4.6 percent. Individuals receiving treatment experienced a 6 percent reduction in blood pressure control.

According to the AHA, almost have of American adults have hypertension. Normal systolic blood pressure is defined as under 120 mmHg, and elevated systolic blood pressure is at 120 to 129 mmHg. Meanwhile, those with high blood pressure fall in the range of 130 to 139 mmHg, according to the AHA. Higher than 180 is considered to be a hypertensive crisis.

The AHA recommends regularly getting your blood pressure checked, limiting alcohol, quitting smoking, and eating a balanced diet, among other practices, in order to get your blood pressure to a healthy level.

Study authors expected age, ethnicity, and race to play a role in the decline of blood pressure control, but instead found that the rates had lowered similarly across all demographics. Egan suggested that the quality of care when it comes to hypertension may be declining, as healthcare access was largely the same among the cohort. This could be due to physicians being overwhelmed by a multitude of chronic conditions.

"It's extremely difficult to manage all these conditions in a 15-minute visit," Egan said in the article. "We need new approaches. We need lean, efficient improvement programs, more self-monitoring, and better public health campaigns to engage patients and get them to understand their hypertension."

The declining rates of control may be associated with rising rates of other chronic conditions like obesity and diabetes. Another recent AHA study found that more than half of Black individuals in the US have hypertension.

“Improving hypertension control and reducing disparities require greater and more equitable access to high quality health care and healthier lifestyles,” the study stated.

Recent research has suggested that race and socioeconomic factors may lead to differing heart failure outcomes among Black and White men. Social determinants of health can lead to significant health disparities, causing poor health outcomes and an overall decline in population health.