The prestigious Institute of Medicine said Monday that even though nearly one in three adults has hypertension, and it's on the rise, fighting it apparently has fallen out of fashion: Doctors too often don't treat it aggressively, and the government hasn't made it enough of a priority, either.
Yet high blood pressure, the nation's second-leading cause of death, is relatively simple to prevent and treat, the institute said.
"There's that incredible disconnect," said Dr. David Fleming, Seattle-King County's public health director and chairman of the IOM committee that examined how to trim the toll.
"In our country, if you live long enough, you're almost guaranteed to get hypertension, so this is something we should all be concerned about," added report co-author Dr. Corinne Husten of the nonprofit Partnership for Prevention.
This is not rocket science, the report makes clear: Cut the salt. Eat more potassium. Get some exercise. Drop 10 pounds. Those steps could make a big difference in how many people suffer high blood pressure 73 million at last count. Another 59 million are on the brink, with blood pressure hovering at levels officially deemed pre-hypertension.
So the institute urged the Centers for Disease Control and Prevention to push doctors to better treat hypertension, and to work with communities to make it easier for people to live the healthy lifestyles that can prevent it.
Hypertension competed with other disorders for the $54 million that CDC spent on heart disease and stroke prevention last year, while it cost the health care system at least $73 billion, the institute noted.
High blood pressure is sinister because it's silent. People seldom notice symptoms until their organs already have been damaged. Hypertension triggers more than one-third of heart attacks, is a leading cause of strokes and kidney failure, and plays a role in blindness and even dementia.
Normal blood pressure is measured at less than 120 over 80. Anyone can get high blood pressure, a level of 140 over 90 or more. But leading risk factors are getting older, being overweight and inactive, and having a poor diet.
Among the committee's findings:
-Too many doctors ignore hypertension if only the top number in a blood pressure reading the systolic pressure is high. That's contrary to treatment guidelines.
-Too little potassium and too much sodium fuel high blood pressure, and only 2 percent of adults eat enough potassium, which is found in fruits and vegetables.
-CDC should work with food makers to lower the sodium hidden inside processed foods, our main source of sodium. The average adult is thought to eat about 3,400 milligrams of sodium a day; the recommended daily limit is 2,300 mg.
-If everyone who is overweight lost 10 pounds, the nation's hypertension cases could drop 8 percent.
-The government should work with insurers to reduce or eliminate copayments for blood pressure medications, and with drug companies to simplify patient-assistance programs for the poor.
The Institute of Medicine is part of the National Academies, an independent organization chartered by Congress to advise the government on scientific matters.