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Docs Undertreating High Blood Pressure


WebMD Health News
Reviewed by Gary D. Vogin, MD

Feb. 25, 2002 -- Studies continue to show that people with high blood pressure aren't getting their numbers down like they should -- leaving themselves at increased risk of heart attack, stroke, and kidney failure. But a new study shows that one big part of the problem may be that doctors are choosing to ignore high blood pressure until it reaches a more dangerous level.

Studies have shown that most people with high blood pressure aren't getting adequate treatment, according to the researchers. It's well known that walking around with a blood pressure 140/90 or over can be deadly. So why are so few people getting their blood pressure down to where it needs to be?

UCLA researchers did a study to answer just that question. They identified 231 people with out-of-control high blood pressure. Each person saw their doctor, and the researchers then asked each doctor questions about treating blood pressure.

What they found is very disturbing. Their results appear in the Feb. 25 issue of the Archives of Internal Medicine.

Despite the persistently high blood pressure, the doctors opted to change or start medication to lower blood pressure only 38% of the time.

The most common reason for not trying to get the blood pressure lower was that the doctors were satisfied with the current blood pressure -- in spite of many studies showing that long-term high blood pressure can do much harm.

At over 90% of the doctor's visits, the systolic blood pressure -- the top number -- was 140 or higher. This is above the cut-off point set by an expert committee on high blood pressure.

In fact, the systolic blood pressure was over 150 at 35% of the visits. On average, a systolic blood pressure of 150 was considered by the doctors to be the lowest point at which they felt a change was needed.

The researchers say that this has an important impact on our country's health given the known association between high systolic blood pressure and heart disease and stroke.

People often ask "Which blood pressure number is more important, the top or bottom?" The answer is that they are both equally important. We used to think that the top number was more important. Then the bottom number was thought to be key. But research now shows that it's important to get both numbers down -- the systolic "top" number to less than 140, and the diastolic "bottom" number less than 90.

And for some people, such as those with diabetes, these numbers should be less than 120 and 80.

Too many people have out-of-control high blood pressure. Both doctors and patients need to work together to treat this problem aggressively -- potentially saving thousands of lives.

Let your doctor know that you want to get your blood pressure down. It can be done, but the two of you need to work together.

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