You're still young, in your late teens or early twenties. And you feel healthy, with no obvious symptoms of any disease. Nevertheless, because you're an intelligent person and want to be proactive with regard to your health, you visit your doctor at least once a year. During those visits, the doctor always takes your blood pressure. So if the doctor hasn't ever said anything about you having high blood pressure, you don't have it, right?
Wrong. A new study shows that if you are between the ages of 18 and 24, you are 28% less likely to be diagnosed with high blood pressure than if you were over the age of 60, even if your blood pressure is as high as the over-60 patients.
Hypertension kills, and it's going undiagnosed
According to the Centers for Disease Control and Prevention, high blood pressure (or hypertension) affects 1 in 3 Americans, or an estimated 60 million people. A 2010 study reported that high blood pressure costs Americans an estimated 95 million dollars per year in health care services, medications, and lost days of work. Hypertension is recognized as greatly increasing a person's risk of heart disease (the #1 cause of death in the U.S.) and stroke (the #3 cause of death in the U.S.). And a 2011 study published in Epidemiology found that nearly 20% of young adults aged 24-32 are affected by high blood pressure. So high blood pressure is a pretty serious problem, right, and those who have it should be warned so that they can begin treating it, right?
Wrong. That would seem to be logical, but the results of a new study presented at a recent meeting of the American Heart Association indicate that this isn't happening. The researchers, from the University of Wisconsin School of Medicine and Public Health, examined the electronic health records of 13,593 male and female patients who were all at least 18 years old. All had visited their doctors at least twice in the previous three years, and all had elevated blood pressure readings high enough to qualify them for a diagnosis of hypertension.
Yet, even after four years of visiting their doctors regularly, 67% of the 18-to-24-year-old patients with high blood pressure had never been diagnosed as having it. 65% of 25-to-31-year-old patients and 59% of 32-to-39-year-old patients with high blood pressure remained undiagnosed. Heather Johnson, lead author of the study, says, "These young patients come to the clinic and their blood pressure is recorded. They have high blood pressure, but there's no documentation of a diagnosis. We wanted to find out why."
Early diagnosis of high blood pressure is critical, but it's not happening
The researchers found many reasons why doctors recorded blood pressure levels high enough to deserve a diagnosis of hypertension, but failed to make such a diagnosis. Young people who smoked were less likely to have their high blood pressure diagnosed, possibly because the doctors associated their elevated blood pressure with smoking rather than as a long-term condition. In general, they found that (for whatever reason) female doctors were more likely to diagnose high blood pressure than male doctors, and that doctors specializing in internal medicine were more likely to diagnose it than family practitioners. Also, the milder the level of hypertension found in the patient, the less likely it was that they were ever diagnosed as hypertensive, even though their blood pressure levels themselves qualified them as hypertensive.
These finding are upsetting because, as Dr. Johnson says, "We know that once high blood pressure is diagnosed and young adults receive the treatment they need, they can achieve pretty high control rates." But because their hypertension is not being diagnosed, these young people are not receiving treatment for it. Johnson says that she hopes her study will help to change things, and that her findings will "guide both patient and provider to make elevated blood pressure one of the key things to focus on during the visit."