A new study says the U.S. is moving in the right direction when it comes to treating high blood pressure, but isn't doing as well in terms of getting to the root of the problem.
Federal health officials released a report last week that said the prevalence of high blood pressure in the U.S. rose about 10 percent between 2005 and 2009.
Now a new study in the peer-reviewed journal PLOS One looked at more than 3,100 U.S. counties - including Los Angeles County. It found that an estimated 38 percent of men and 40 percent of women had high blood pressure, also known as hypertension, in 2009.
Control of high blood pressure is on the rise, said the study's authors, but the condition itself continues to become more common. Last year, the Centers for Disease Control and Prevention (CDC) said more than 31 million people have high blood pressure but don't have it under control.
Researchers on the PLOS One study described their findings thus:
Increasing trends in hypertension awareness, treatment, and control suggest that campaigns to increase hypertension awareness and treatment have been successful. Furthermore, prevalence of uncontrolled hypertension is on the decline. … Yet, with few exceptions, the range of total hypertension prevalence within any given state increased between 2001 and 2009.
In other words, the U.S. is moving in the right direction when it comes to treating high blood pressure, but isn't doing as well in terms of getting to the root of the problem.
Focusing on L.A. County
The study's analysis of Los Angeles revealed the following about the county's women in 2009:
- About 39 percent had high blood pressure; of those women, more than 3 in 4 knew it.
- More than 2 in 3 women with high blood pressure were undergoing treatment, which was lower than the national rate.
- Slightly more than half have their blood pressure under control.
- About 1 in 5 of the total female population in L.A. County had uncontrolled high blood pressure.
As for their male counterparts:
- About 35 percent have the condition; 4 in 5 of those men were aware of it.
- Like women, more than 2 in 3 with high blood pressure are undergoing treatment, which is still below the national rate.
- Slightly more than half have it under control.
- Seventeen percent of L.A. County's men had uncontrolled high blood pressure.
Since 2001, the prevalence of hypertension among both men and women increased. Prevalence among African-Americans was notably higher than among other ethnic minorities: Nearly half of black men and women had high blood pressure. But the study's authors said treatment rates tended to be highest in black men and women.
The condition in South L.A.
High blood pressure in L.A. County is particularly bad on the Southside. Dr. Cesar Barba, the interim medical director of UMMA Community Clinic, recently said that high blood pressure accounts for more than 1 in 5 of their patient diagnoses. All told, UMMA tends to more than 1,200 hypertension patients.
It's a major problem at another area clinic, too. Cynthia Francis, a physician assistant at T.H.E. Clinic, estimates that between 20 and 30 percent of T.H.E.'s patients are hypertensive.
"We're in a community where it's pretty prevalent," she said, noting the large black and Latino population in the area, as well as the widespread low socioeconomic standing.
Francis said how well those patients manage their condition varies.
"When they get good education on modifying what they eat and the importance of exercising, you have a group of patients that do really well and can lower their pressure," she said. "Then there's another group that's a little more difficult."
That group has high blood pressure plus a host of other medical problems – especially mental illness, or issues affecting their mobility.
"If they have other medical problems it's a little more difficult to get them to work with just diet and exercise," she said.
High blood pressure is difficult to detect without specifically testing for it, but Francis said there are a few things that should prompt people to get themselves to a health provider:
- "If your abdomen is bigger than your butt – if your waistline is bigger than your rear line – chances are you need to assessed for high blood pressure," she said.
- But you can be slim and still have high blood pressure, especially if it runs in the family. Some patients with undiagnosed hypertension come into T.H.E., said Francis, "and one of the first things you find out is their brother has it, the mother has it, the father had it."
- "If you're a person who doesn't like to work out, who never really had an exercise program, come get your blood pressure checked," she said.
Francis recommended that folks who don't know anything about their blood pressure take advantage of free health fairs or the self-testing kiosks at places like Walgreens, CVS or Costco to get a reading on it.
When uncontrolled, high blood pressure can lead to cardiovascular disease, heart attacks, stroke, kidney disease and vision problems.
"That's a lot, and it's really important we paint that picture," said Francis. "Even when patients are prehypertensive, it's really important to paint the picture of what we call end organ damage, and that if we don't control it, then you're at risk for all these end organ problems."
End organ damage refers to the way an organ is ultimately affected by a chronic disease like hypertension or diabetes.