Many Americans have uncontrolled hypertension reports CDC

Robin Wulffson MD's picture

More than 50% of Americans have uncontrolled hypertension, according to the Morbidity and Mortality Weekly Report (MMWR), which was released on September 4 by the Centers for Disease Control and Prevention (CDC). The agency notes that hypertension is a leading risk factor for cardiovascular disease, a major cause of morbidity and mortality, and costs $131 billion annually in healthcare expenditures.

The MMWR accessed data from the National Health and Nutrition Examination Survey (NHANES) to examine awareness and pharmacologic treatment of uncontrolled hypertension among US adults with hypertension. NHANES is a complex, multistage probability sample of the U.S civilian, non-institutionalized population.

The researchers focused on three groups: those who are unaware of their hypertension; those who are aware but not treated with medication; and those who are aware and pharmacologically treated with medication but still have uncontrolled hypertension.

The investigators analyzed data from the NHANES from 2003 through 2010 to estimate the prevalence of hypertension awareness and treatment among adults with uncontrolled hypertension in the nation. Hypertension was defined as: an average systolic blood pressure 140 mm Hg or higher; an average diastolic blood pressure 90 mm Hg or higher; or currently using blood pressure –lowering medication. Uncontrolled hypertension was defined as: an average systolic blood pressure 140 mm Hg or higher; or an average diastolic blood pressure 90 mm Hg or higher


The researchers found that the overall prevalence of hypertension among U. adults aged 18 years or older in 2003−2010 was 30.4% (an estimated 66.9 million). Among those with hypertension, an estimated 35.8 million (53.5%) did not have their hypertension controlled. Among these, an estimated 14.1 million (39.4%) were not aware of their hypertension, an estimated 5.7 million (15.8%) were aware of their hypertension but were not receiving pharmacologic treatment, and an estimated 16.0 million (44.8%) were aware of their hypertension and were being treated with medication. Of the 35.8 million US adults with uncontrolled hypertension, 89.4% reported having a usual source of healthcare, and 85.2% reported having health insurance.

The authors concluded that almost 90% of US adults with uncontrolled hypertension have a usual source of healthcare and insurance; thus, this situation represents a missed opportunity for hypertension control. They noted that improved hypertension control will require an expanded effort and an increased focus on blood pressure from healthcare systems, clinicians, and individuals. They stressed that the findings can be used to target populations to improve hypertension control in the United States.

In addition to the MMWR, the CDC encompasses other ongoing endeavors. A proactive program known as Million Hearts is a US Department of Health and Human Services initiative co-led by CDC and the Centers for Medicare & Medicaid Services. It is focusing efforts on a common goal of preventing 1 million heart attacks and strokes by 2017. Focused clinical and policy strategies and more effective application of health information technology are being used to improve the clinical management of hypertension, along with interventions such as aspirin therapy, cholesterol management, and smoking cessation. With respect to hypertension, this initiative has the goal of increasing by 10 million the number of persons in the United States whose hypertension is under control, which will help reach the objective of preventing 1 million heart attacks and strokes by 2017.

Take home message:
Hypertension is known as the silent killer because symptoms often are vague. It is a simple matter to have one’s blood pressure checked. This is a usual component of a routine medical examination. Many drug stores offer free blood pressure checks. Have you had your blood pressure checked recently?

Reference: CDC