High blood pressure may be one of the pre-existing conditions that make people more vulnerable to complications from COVID-19. Unfortunately, an analysis published in JAMA reveals that an increasing proportion of Americans now have uncontrolled hypertension (JAMA, online, Sept. 9, 2020).
How Do Scientists Define Uncontrolled Hypertension?
Data on 18,262 patients with high blood pressure were collected through the National Health and Nutrition Examination Survey (NHANES) in 2013 and 2014 and again in 2017 and 18. The investigators considered that blood pressure was under control if the top number (systolic pressure) was under 140 and the bottom number (diastolic pressure) was under 90.
At the beginning of the decade, only 32 percent of NHANES participants with elevated blood pressure had it under control. By 2007 and 2008, that proportion was up to 48.5 percent. Again, in the 2013-14 sample, 54 percent of people with high blood pressure had it under control. Four years later, that rate had dropped to 44 percent. Alarmingly, that figure implies that more than half of blood pressure patients–56 percent–had uncontrolled hypertension.
People who had health insurance, a primary care provider and a regular health care “home” were more likely to have their blood pressure below 140/90. Current guidelines set the limits of controlled blood pressure at 130 over 80. Applying that more stringent criteria means even fewer patients have their blood pressure where it should be. Older individuals and people of color may have particular challenges in this regard.
What Should You Do About Your Blood Pressure?
The authors cite lack of information about diet and lifestyle as a limitation of the study. Nonetheless, most experts agree that people can gain better control if they quit smoking, monitor their blood pressure at home and adopt nondrug approaches such as exercise and diet in addition to taking medication. In addition, those with persistent uncontrolled hypertension may need more than one type of medicine to lower it.
Learn More:
We have summarized information on antihypertensive medications and nondrug approaches in our eGuide to Blood Pressure Solutions. This online resource includes discussion of white coat hypertension, home blood pressure monitors and the DASH diet, along with summaries of information on ACE inhibitors, ARBs, beta blockers, calcium channel blockers and diuretics.
