High Blood Pressure in the US: A Pharmacological and Cultural Problem

 

Extracted from source 3: Holland, K. (2020, June 17). High Blood Pressure: Causes, Symptoms, Medication, Diet, and More. Retrieved October 03, 2020, from https://www.healthline.com/health/high-blood-pressure-hypertension 

     It is no surprise that high blood pressure remains a growing problem in the United States. In 2018, alone half a million deaths were attributed to complications associated with hypertension (1). The current leading cause of death for the United States is heart disease with hypertension contributing greatly to the fatalities (2). With a rise in the overall number of hypertension cases in the US, the amount of prescribed blood pressure medication has also been on the rise. Currently, the American Heart Association guidelines define hypertension as a blood pressure at or above 130/80 mmHg with stage 2 hypertension being above 140/90 mmHg (1). The current treatment for diagnosed high blood pressure is usually a high blood pressure medication (4). Common hypertension medications include diuretics, beta blockers, ACE inhibitors, alpha blockers, calcium channel blockers, and central agonists. Medication options are prescribed by the physician based on their potential to alleviate the symptoms that the patient presents as well as incur the side effects. Most treatment options are coupled with medication as well as changes in lifestyle to help alleviate symptoms of high blood pressure. Unfortunately, it appears that most patients are reluctant to major lifestyle changes but instead prefer to rely on the use of medications. 

    With the increasing percent of the population succumbing to high blood pressure and the associated cardiovascular diseases, it is important to spread awareness of treatment options as well as advocate for lifestyle changes. Unfortunately, the issue of high blood pressure is very complicated and ingrained within layers of socioeconomic and health predispositions. While blood pressure medications have been shown to significantly reduce the risk of cardiovascular disease, taking these medications in concert with a healthy lifestyle and diet are also important. 

Image extracted from source 1: Facts About Hypertension. (2020, September 08). Retrieved October 03,  2020, from https://www.cdc.gov/bloodpressure/facts.htm 

    It is also important to acknowledge that cases of hypertension have increased with change in diagnostic guidelines as well as the increased availability of healthcare services in less affluent areas. Most high blood pressure cases in the United States have appeared to be in the southern regions with 32 – 38% of adults 20 years and older being diagnosed with hypertension (1). Young adults in the US have been shown to have increased sodium and potassium in their diets that have helped to contribute to increased levels of high blood pressure (7).  In other countries, it has be shown that governmental regulations to lower salt concentrations by 30% has led to a reduction of 10 mmHg in the average population (8). Other ways to help lower high blood pressure without the use of medication include regular exercise, healthier diet, limiting caffeine and alcohol use, cutting out smoking, and reducing daily stress(9). Ultimately the use of medications to lower hypertension is effective, but it is important to improve daily lifestyle habits in order to continually improve blood pressure. The use of medication is not intended to be used to maintain the diet and lifestyle that had led to the initial hypertension.  

Image extracted from source 11:  Socioeconomic Environment. (n.d.). Retrieved October 03, 2020, from https://www.healthandenvironment.org/environmental-health/environmental-risks/socioeconomic-environment 

    Ideally, the goal would be to overall lower the number of hypertension cases in the United States, however it is important to acknowledge the many barriers that limit this success. Unfortunately, studies have shown that socioeconomic status is directly tied to increased risk of developing cardiovascular disease (10). Lower income areas have less access to both healthy foods as well as workout facilities that are prominent in much more affluent areas. This perpetuates the cycle of increased blood pressure as lower income families are not only constantly under immense stress financially, but also faced with the fact that heavily processed foods are more readily available and cheaper than fresh produce. Not only are they disadvantaged with the limited resources available, but also, they are less likely to seek medical care unless necessary due to fear of healthcare costs.  

    While it is encouraging that there has been more attention focused on the prevalent problem of increased blood pressure in the United States, it is important to understand this problem is not easily fixed by just prescribing hypertension medication. These medications do help to decrease blood pressure in patients that have already presented hypertension symptoms, however it is equally crucial to focus on preventative measures. There must be efforts in culturally changing lifestyles and diet by making healthier food options readily available as well as providing opportunities to improve the overall health of those that would not have the opportunity otherwise. The problem has been identified and medications have been used to mitigate outcomes, but the focus must turn to preventing the problem in the first place.  

By James Warinner, A Master of Medical Science Student at the University of Kentucky 

 References

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https://www.healthline.com/health/high-blood-pressure-hypertension
4. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. (2003). McLean, VA: International Medical Pub.
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doi:10.1093/ajh/hpx085
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904- 909. doi:10.1111/jch.13014
8. Barrera, L. (2018). High Blood Pressure prevention and control: From evidence to action. Colombia Médica, 49(2), 137-138. doi:10.25100/cm.v49i2.3940
9. 10 drug-free ways to control high blood pressure. (2019, January 09). Retrieved October 03, 2020, from https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974
10. Conen, D., Glynn, R. J., Ridker, P. M., Buring, J. E., & Albert, M. A. (2009). Socioeconomic status, blood pressure progression, and incident hypertension in a prospective cohort of female health professionals. European Heart Journal, 30(11), 1378-1384. doi:10.1093/eurheartj/ehp072
11. Socioeconomic Environment. (n.d.). Retrieved October 03, 2020, from
https://www.healthandenvironment.org/environmental-health/environmental-
risks/socioeconomic-environment