New Research Focuses on Blood Pressure Control (Part 1)

As an article published in The New York Times earlier this week (and blogged about on by Jan Chait and Eric Lagergren) stated, controlling cholesterol and blood pressure levels are crucial for staving off heart disease in people with diabetes. And indeed, high blood pressure, or hypertension, is a hot topic right now, as multiple new studies have addressed the rate at which it is diagnosed, the damage it can do, and ways of lowering it.

Two new studies published in The Journal of the American Medical Association (JAMA) this week focus on hypertension. The first found that hypertension—which is often referred to as the “silent killer” in adults because it produces no obvious symptoms—is very often undiagnosed in children and adolescents. The study included more than 14,000 people 3-18 years of age who over a seven-year period received at least three checkups at which their blood pressure levels were recorded. The researchers found that of the 507 children and adolescents whose blood pressure readings over that period met the criteria for high blood pressure, only 26% had received an official diagnosis of hypertension. Of the 485 children whose blood pressure fell into the prehypertension range (elevated blood pressure levels that have not reached the threshold for hypertension), only 11% had received an official diagnosis of prehypertension. Participants were more likely to be officially diagnosed with one of these conditions if they were older, taller, had been diagnosed with obesity, had a greater number of elevated blood pressure readings, or had higher overall blood pressure readings.

High blood pressure can be difficult to diagnose in children, for whom normal values vary greatly depending on age, height, and sex. However, doctors commenting on the study have expressed concern at the rate of underdiagnosis, which can set children up to have high blood pressure for decades without knowing it while it does damage to their hearts, kidneys, and other organs.

Another study published in the same issue of JAMA reviewed 44 previous studies about prevention and treatment of diabetic eye disease, or retinopathy. The studies included in the review were randomized and controlled, and the researchers followed up with their participants for at least one year. The review found that tightly controlling blood glucose and blood pressure levels are the most effective ways a person can prevent diabetic retinopathy and slow its progression.

Next week, will report on two more studies that highlight ways people can control blood pressure and cardiovascular disease risk through diet.