Lots of Americans have a blood pressure problem, but plenty aren’t doing much to remedy it, according to research published today.
Scientists studied nationally representative data from Americans over the age of 20. Nearly 80% of people with hypertension did not have it under control, they found; even worse, a majority of people with uncontrolled hypertension were not taking any pressure-lowering drugs. The findings suggest these drugs can have a big positive impact on Americans’ cardiovascular health, the researchers say—provided they’re able or willing to accept treatment.
“Many could potentially achieve [blood pressure] control with initiation of antihypertensive medication and lifestyle modification,” they wrote in their paper, published Monday in JAMA.
Silent but deadly
Hypertension is defined as having systolic blood pressure 140 mm Hg or greater (the top number in a blood pressure reading) and diastolic blood pressure 90 mm Hg or greater (the bottom number). It’s considered uncontrolled when the condition is untreated or blood pressure remains high even with treatment.
High blood pressure on its own usually doesn’t cause visible symptoms. But over time, it can raise the risk of other life-threatening conditions like heart attack, stroke, and kidney disease, especially if not managed well. According to the Centers for Disease Control and Prevention, hypertension contributed to 664,470 American deaths in 2023.
The American Heart Association recommends using a combination of lifestyle changes and medication to lower the blood pressure of people with hypertension to below 130/80 (such a change might include reducing sodium in your diet). The researchers wanted to get a sense of how many Americans aren’t reaching that goal and why, so they examined data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative poll of Americans’ dieting and lifestyle habits run by the CDC.
Between 2021 and 2023, 47% of Americans had hypertension, based on NHANES data. During those years, 79% of people with hypertension had uncontrolled blood pressure, the researchers found. Of those with uncontrolled blood pressure, nearly two-thirds (61%) reported not being on medication.
The good and bad news
While it’s possible that some people will still have hypertension even with treatment, greater adoption nationwide could certainly move the needle. Two-thirds of people with uncontrolled blood pressure had it within 10 points of the recommended goal, the researchers noted, indicating many could reach it with enough help. And there do seem to be tangible ways to start bridging that gap.
Though most people with untreated hypertension had health insurance or a routine place to get health care (over 80%), for instance, rates of having either were significantly lower compared to people with controlled hypertension. For others, it might simply be a matter of awareness. A 2024 study found that 40% of Americans with hypertension don’t even know they have it, while most Americans struggle to understand what their blood pressure readings actually mean.
If you suspect that you could have hypertension, or even if you just haven’t had your blood pressure checked out in a while, it’s probably worth making sure you get screened for it at your next doctor’s visit.
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