Changes in hypertension awareness, treatment, and control rates 20-Year trend data

doi:10.1016/1047-2797(93)90114-J

Annals of Epidemiology

Volume 3, Issue 5, September 1993, Pages 547-549

https://doi.org/10.1016/1047-2797(93)90114-J Get rights and content

Abstract

In the last 2 decades, public knowledge, awareness, treatment, and control of high blood pressure have changed remarkably. These changes are real, and have been associated with the activities of the National High Blood Pressure Education Program. Without a control group it is always difficult to attribute causality; however, the improving levels are remarkably large and consistent, and they have occurred concurrently with the decline in age-adjusted stroke mortality.

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Cited by (36)

Updated American Heart Association/American College of Cardiology; European Society of Hypertension/European Society of Cardiology Guidelines
2018, Hypertension: A Companion to Braunwald's Heart Disease
Task force #3 - Getting results: Who, where, and how?
2002, Journal of the American College of Cardiology
Citation Excerpt :
The reports have been distributed to all state health departments, nearly every primary care clinician, and all hypertension control programs in the nation and have been translated into foreign languages as well. Identification, treatment, and control of high BP improved significantly between the time that the NHBPEP was organized and the early 1990s (8). More recently, however, control of high BP has declined significantly in at least some venues (9).
Effective strategies for blood pressure control
2002, Cardiology Clinics
Using entertainment television to build a context for prevention news stories
2000, Preventive Medicine
Objective. A nationally syndicated television news series called “Following ER” was developed to educate viewers about the health issues dramatized on “ER,” NBC's award-winning medical drama. This study investigated the impact of this prime-time link on viewer attention, satisfaction, information recall, and perceptions about the uses and gratifications delivered by a news story.
Methods. A total of 458 municipal jurors participated in a randomized 2 (“ER” tie-in vs no tie-in) × 2 (familiar vs novel story topic) experiment. The four experimental news stories required by this design were developed using footage of previously aired local newscasts.
Results. In the case of the familiar topic story, the “ER” tie-in enhanced the attention and satisfaction of viewers. Participants reported that the prime-time link added value by elevating the importance and relevance of the commonplace topic. However, the “ER” tie-in did not generate any beneficial effects when paired with the novel topic story.
Conclusions. Framing news stories about familiar health concerns in the context of television drama represents a viable strategy for legitimizing them as important and timely topics for public consumption and debate.
Stroke subtypes and risk factors in patients living in Southern Seoul, Korea: The impact of hypertension control on stroke subtypes
1998, Journal of Stroke and Cerebrovascular Diseases
Background and Purpose: The prevalence of hypertension (HT) does not explain the relatively high incidence of hemorrhagic stroke in Korea and other Asian countries, and whether HT has a greater impact on development of the intracerebral hemorrhage (ICH) than cerebral infarction (CI) remains unclear. It may be speculated that the adequacy of HT control is related to the subtype differences. The present study was aimed to elucidate (1) whether various risk factors exert a different impact on stroke subtypes and (2) whether the adequacy of HT control in patients with a previous history of HT is related to different subtypes in stroke patients from southern Seoul, Korea. Methods: We prospectively studied 602 consecutive patients with acute stroke (CI and ICH) admitted to the Asan Medical Center and analyzed their stroke subtypes and risk factors. The mode of HT treatment before the stroke onset was specifically asked. We examined whether various risk factors were related to subtype differences in these patients. We also attempted, in patients with a prior history of HT, to see whether the mode of HT control was related to the subtype differences. Results: 75.8% of the patients had CI (large vessel infarction 33.8%, small vessel infarction 22.1%) and 24.2% had ICH; 75% of the patients had HT of whom the presence of HT was previously unidentified in 8%. Previous treatment of HT was considered adequate in 32.4% and inadequate in the others. On multiple logistic analysis, diabetes mellitus and alcohol drinking were independently related to CI (v ICH), whereas HT did not favor any stroke subtypes. However, in patients with a prior history of HT, previous mode of HT control was a significant factor related to subtype differences in a way that inadequate treatment favored ICH. There were no specific risk factors that independently discriminate large vessel infarction versus small vessel infarction. Conclusions: Apparently, HT was not a risk factor that preferentially favors any specific stroke subtypes in patients from southern Seoul. However, in patients with HT, previous mode of HT control was an important factor influencing the subtypes. Inadequate treatment of HT may play a role, at least in part, on the relatively prevalent ICH and hence the greater significance of stroke as a cause of death in Korea compared with Western countries.
HDL cholesterol: Trends in two Southeastern New England communities, 1981-1993
1998, Annals of Epidemiology
PURPOSE: Although public health interventions have not specifically targeted high density lipoprotein (HDL) cholesterol, observed changes in the prevalence of other cardiovascular risk factors would be expected to have differential effects on HDL. This study examined secular trends in HDL in relation to changes in other cardiovascular risk factors for the years 1981 through 1993 in the Pawtucket Heart Health Program (PHHP) study communities.
METHODS: Nonfasting HDL levels were assessed in 12,223 respondents to six biennial population random sample surveys.
RESULTS: Between 1981 and 1993, mean HDL cholesterol declined by 0.08 mmol/L in both men and women after adjustment for age, city, education, hormone use, medications, recent alcohol use, smoking, regular exercise, body mass index (BMI), and total cholesterol, (p for trend < 0.001). There was no apparent laboratory explanation for the trend which occurred concurrent with decreased smoking prevalence, increasing BMI and decreased prevalence of recent alcohol use. Decreasing HDL cholesterol was observed consistently across subgroups defined by smoking, alcohol use and BMI.
CONCLUSIONS: Although several favorable cardiovascular risk factor trends have been observed in recent decades, declining HDL cholesterol is also of interest, particularly in conjunction with population increases in BMI.

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