High blood pressure, or hypertension as the disease is known medically, is our most common chronic illness. Estimates of exactly how many Americans have high blood pressure vary—the American Heart Association and the National Heart, Lung, and Blood Institute put the figure at about 55–60 million, but some of the individuals included in this estimate may only have had transient elevation of pressure; a more accurate estimate is probably 35–40 million. In either calculation, the number of people affected and the amount of the nation’s health budget that goes toward treating high blood pressure or its complications are huge. Because high blood pressure is the leading cause of strokes and a major risk factor for heart attacks, one of the most important aspects of preventive cardiology
should be to identify as many people who have the disease as possible and to take steps to lower the blood pressure before it causes damage to the blood vessels, heart, kidneys, eyes, and other organs. Fortunately, the last 30 to 35 years have seen remarkable advances in the treatment of high blood pressure, with major payoffs. The death toll from strokes is down by more than 54 percent and heart attack mortality has dropped by more than 45 percent since 1973–74. At that time, the National High Blood Pressure Education Program directed at both physicians and the general public raised consciousness about the dangers of untreated high blood pressure and the importance of early effective treatment. We are now reaping the benefits of this and other major programs. Even so, it’s still too early to declare victory over high blood pressure. Despite massive public education programs, misconceptions about the disease abound. Many people still harbor misconceptions about what constitutes an elevated blood pressure (see box, “Common Facts and Myths”), and there probably still are many people whose high blood pressure has not been diagnosed—especially in minority populations. There also are several millions of others whose hypertension has been diagnosed but who are not being adequately treated to normal blood pressure levels. |