Poorly treated high blood pressure leads to heart disease

Written by By Meg Wagner, CNN

Nearly 1 in 5 adults in the United States has high blood pressure, a prevalence rate that’s up from 8% in 1980, according to a report by the US Centers for Disease Control and Prevention.

Even though the number of people with high blood pressure has grown, the rate of people taking medication to control it has not.

That’s one finding of the most recent report on high blood pressure in the US. Since 1980, the report found, the proportion of adults taking blood pressure medication grew from 53% to 65%. But only 45% of them were taking medications that contain niacin, which some believe can potentially increase blood pressure.

Another 11% of adult diabetics were taking niacin-containing medications.

Niacin has been known for decades to increase blood pressure in high doses. So, even though only 5% of people take niacin-containing medications, those people are at high risk of having high blood pressure, said Dr. Justin Bremner, the senior author of the study and a specialist in cardiovascular disease at the CDC.

“The number of people taking the drugs does not change the number with treatment, so the focus in practice is getting niacin users onto lower blood pressure drugs,” Bremner said.

If patients stop taking niacin, their blood pressure goes up again.

Dr. Nicole Mobley, a cardiologist at Mayo Clinic in Jacksonville, Florida, called the report “astounding.”

“The lack of knowledge, understanding and guidance among patients about the effects of niacin is simply stunning,” Mobley said. “I think we need to be leading the charge on education.”

The vast majority of diabetics and adults with hypertension use medication, the study showed. The prevalence of high blood pressure is “almost imperceptible” among blacks and women, the report found.

During the years of the study, the racial disparity grew more pronounced.

In 1982, the proportion of adult black Americans who were taking high blood pressure medications was 10%.

In 2011, 9% of African-Americans were taking medication.

In 2011, 8% of Hispanic adults were taking medication.

From 2010 to 2015, the prevalence of high blood pressure increased among all races, between 1.5 and 2 percentage points.

According to the CDC report, the greatest increase in prevalence was among Hispanic adults, which went from 10% to 19%. The racial disparity for high blood pressure among Hispanics grew from 5 to 16%.

Overall, white adults had the lowest prevalence of high blood pressure, which stayed between 11% and 12%.

“There are still people that need help controlling their blood pressure, and there’s still a lot of medical care that needs to be done,” Bremner said.

The US Heart Association and American Heart Association are sponsoring a “National High Blood Pressure Week” to draw attention to the need for more education and further research. The CDC said more research is needed to fully understand the effects of niacin on blood pressure, and not all blood pressure control methods may be equally effective.

In general, high blood pressure is risk factors for heart disease and stroke.

High blood pressure can affect anyone and be caused by weight gain, smoking, being overweight and impaired weight management. People with hypertension have a higher risk of developing strokes, heart attacks and heart failure.

“Prevention and treatment of high blood pressure is a public health priority, and this week-long reminder to reduce risk increases awareness and provides a strong opportunity to raise awareness about the health implications of high blood pressure,” said Ron Ohman, executive director of the American Heart Association and American Stroke Association, which co-sponsor the week of events.

There is a vaccine that can lower blood pressure in children, but it is not available for adults. Women who are pregnant should get the vaccine to protect their babies.

Health providers should be more aware of the effect of niacin and be willing to ask patients if they are taking niacin, Bremner said.

“I think niacin needs to be the baseline,” he said. “It’s a screening tool that allows you to detect patients with hypertension that might not otherwise be diagnosed.”

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