- A national study assessed changes in the proportion of adults unaware of their hypertension, diabetes, or high cholesterol level in the last decade.
- Awareness of diabetes and high cholesterol was stable, but the proportion of Americans not realizing they had high blood pressure rose.
- Adults ages 20 to 44 who were unaware of having hypertension surpassed one in three as recently as 2023.
High blood pressure (BP) awareness increasingly slipped under the radar since the COVID-19 pandemic, according to nationally representative health data.
Results from National Health and Nutrition Examination Survey (NHANES) cycles, spanning the years 2013 to 2023, showed no improvement in the proportion of adults having hypertension, diabetes, and high cholesterol who self-reported being unaware and never diagnosed. In fact, hypertension awareness stood out for trending significantly in the wrong direction:
- Adults with hypertension not realizing it: 14.6% in 2013-2014 to 17.8% in 2021-2023
- Adults with diabetes not realizing it: 27.5% to 28.9%
- Adults with high total cholesterol not realizing it: 11.5% to 11.9%
"Given declining cardiometabolic health in young adults, it is concerning that approximately one in three with hypertension, two in five with diabetes, and one in four with a high cholesterol level are unaware of having these conditions. Policy efforts to address these gaps in awareness are needed to prevent future cardiovascular events," wrote Rishi Wadhera, MD, MPP, MPhil, of Beth Israel Deaconess Medical Center and Harvard T.H. Chan School of Public Health in Boston, and colleagues in JAMA Cardiology.
Such results support the idea that the COVID-19 pandemic has had wide-ranging health effects, including indirect ones through disrupted medical care, increased sedentary behavior, and worsening psychosocial stressors.
Notably, the researchers reported it was the large jump in adults 20-44 years old unaware of their hypertension (from 21.9% in 2013-2014 to 37.1% in 2023-2024) that drove part of the population-wide increase since COVID-19. For those 45 years or older, there was no discernible increase in hypertension awareness.
Along the same lines, prior work had shown that young adults with diabetes had a sharp decrease in glycemic control comparing NHANES before and after the pandemic.
There was also a disproportionate increase in women, in particular, being unaware of their high BP (from 11.3% to 16.5%) in the present study.
NHANES is a well-known cross-sectional survey of the noninstitutionalized general population in the U.S. Selected participants undergo household interviews, physical assessments, and lab tests. Researchers generally use survey weights from NHANES to generate nationally representative estimates.
Wadhera and colleagues based their study on NHANES cycles from 2013-2014 and August 2021-August 2023. Included were over 15,000 adults age 20 or older with cardiovascular risk factors (mean age 56.8 years, 45.6% women).
For the study, hypertension was defined as elevated systolic BP (≥140mm Hg) or diastolic BP (≥90 mm Hg) or a prescription for antihypertensive therapy. The threshold for diabetes was hemoglobin A1c 6.5% or more, fasting plasma glucose 126 mg/dL or more, or a self-reported clinician's diagnosis. High total cholesterol level was defined as 240 mg/dL or more, or a self-reported clinician's diagnosis.
A major limitation of the analysis, study authors acknowledged, was the reliance on self-reported awareness and medication data.
Disclosures
The study was supported by the Sarnoff Cardiovascular Research Foundation, an American Heart Association Established Investigator award, and a grant from the National Heart, Lung, and Blood Institute.
Wadhera disclosed no relevant ties to industry. A co-author reported relationships with Chamber Cardio and Abbott Vascular.
Primary Source
JAMA Cardiology
Source Reference: Johnson DY, et al "Hypertension, diabetes, and high cholesterol awareness among US adults" JAMA Cardiol 2025; DOI: 10.1001/jamacardio.2025.1536.
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.