Over Half of Adults With Uncontrolled Hypertension Unaware of Their Condition

More than half of U.S. adults with uncontrolled hypertension are unaware they have hypertension in the first place, according to a recent study in JAMA Network Open. Furthermore, more than two-thirds of those on treatment had hypertension that remained uncontrolled.

In this video interview, study author Adam Vaughan, PhD, MPH, of the Division for Heart Disease and Stroke Prevention at the CDC, discusses the results and some possible intervention points.

The following is a transcript of his remarks:

My name is Adam Vaughan. I’m the deputy associate director of science in CDC’s Division for Heart Disease and Stroke Prevention. The paper that we’re discussing today is titled “Examining the Hypertension Control Cascade in Adults With Uncontrolled Hypertension in the U.S.”

Our study looked at the hypertension control cascade among U.S. adults with uncontrolled hypertension. The cascade includes hypertension awareness, hypertension treatment recommendations, and use of antihypertensive medication. By looking at these, we wanted to better understand, at what point in the cascade, action may be most helpful to improve hypertension control in the United States since hypertension control is the leading cardiovascular disease risk factor.

I’ll go over a few of the main points. The first main point that we found was that more than half of U.S. adults with uncontrolled hypertension don’t even know that they have hypertension. Our results were especially striking for adults between the ages of 18 and 44, where 93% of them were unaware that they had hypertension.

We also found very concerning results around blood pressure medication use among this population that has uncontrolled hypertension. Among these adults, more than two-thirds of them know that they have hypertension, are eligible for treatment, and they’re currently taking blood pressure medication. So these people are taking blood pressure medication, but they still don’t have controlled hypertension.

We also found that a large proportion of people who are engaged with the healthcare system, these are people who had more than two visits with healthcare providers in the past year, take blood pressure medication, but remain uncontrolled. So these represent opportunities to engage with the healthcare system and address their lack of hypertension control.

Our results really do point to the importance of hypertension awareness and with meaningful engagement with your healthcare providers. Healthcare providers play a really key role in helping to ensure accurate blood pressure measurements during patient encounters, and they can also ensure appropriate medication dosage, encouraging medication adherence, assisting patients with self-monitoring their blood pressure, and following-up with patients. All of these provider-based actions can help improve hypertension control.

It really also points to the importance of talking to your doctor about hypertension, even if you’re young or if you feel healthy. Talking to your healthcare provider can help you get a diagnosis of hypertension and help you get the treatment that you need to control your hypertension.

One thing that I would like to cover are just some of the numbers, because they’re really impactful in this study: 57.8 million adults in the United States are unaware that they have hypertension, and among 35 million adults who are aware that they have hypertension, and were eligible for receiving antihypertensive medication treatment, 71% of those — which corresponds to 24.8 million Americans — took medication but had hypertension that remained uncontrolled.

So these are really so many millions of opportunities that we have in the United States for addressing hypertension control and improving the burden of cardiovascular disease in this country.