Research from Swedish university shows patients aren’t getting enough medication or have other risk factors not being treated

More than 100 million American adults have high blood pressure, according to the Food and Drug Administration, but only about half have it under control.

Worldwide, more than a billion people are hypertensive, defined as having blood pressure with a systolic level (the higher number) of at least 140 or diastolic level (the lower number) of 90 or higher.

For his thesis at Sahlgrenska Academy, University of Gothenburg, specialist doctor Johan-Emil Bager studied the association between various blood pressure levels and the risk of heart attack or stroke in older patients with hypertension but without a history of heart attacks or strokes.

During his research, Bager found the risk of heart attack or stroke was about 40% lower for patients with systolic blood pressure below 130 compared with those in the SBP 130–139 range. In the latter group, 5.2% of the patients suffered a heart attack or stroke during the follow-up period, compared with 3.4% of those in the group with lower SBP. The study comprised 5,041 older patients.

This pattern was repeated in another study, which investigated the risk of hemorrhagic stroke at different blood pressure levels in 3,972 patients with atrial fibrillation, a common type of heart rhythm disorder. These patients were receiving treatment with blood-thinning drugs, such as Warfarin or Eliquis.

The study showed that patients with SBP ranging from 140 to 179 had a risk of hemorrhagic stroke roughly twice as high as for patients with SBP of 130–139. In the patient group with higher SBP, 1.4% suffered a hemorrhagic stroke during the follow-up period, compared with 0.7% of patients in the group with lower SBP.

In another study, which included data on 259,753 Swedish patients, evidence of insuffiency of treatment in patients with hypertension emerged. Nine out of 10 patients had either insufficient blood pressure control or high blood lipids (cholesterol) or were smokers.

“This means that an overwhelming majority of the patients with high blood pressure are exposed to at least one important, modifiable risk factor for cardiovascular disease and premature death,” Bager said.

He concluded that an unnecessarily high number of people in Sweden suffer MI or stroke, or die prematurely, because of insufficiently treated hypertension.

“Health professionals and patients with hypertension alike need to aim higher when it comes to treating high blood pressure. The vast majority of patients with hypertension could reduce their (myocardial infarction) and stroke risk by lowering their BP and blood lipids with more drugs, or through lifestyle changes.”

Normal blood pressure is 120/80 or lower. Your blood pressure is considered high (stage 1) if it reads 130/80. Stage 2 high blood pressure is 140/90 or higher, according the Centers for Disease Control and Prevention in Atlanta.