Hypertension on rise in L.A. County

Hypertension, the silent killer, is on the rise among Los Angeles County adults. A report issued by the Los Angeles County Department of Public Health indicates that the percentage of adults countywide who have been diagnosed with hypertension increased from 18 percent in 1997 to 25 percent in 2005.

The findings are based on the results of the most recent Los Angeles County Health Survey. The report also provides recommendations for individuals, businesses, cities and communities to help reverse or reduce the upward trend.

"Hypertension or high blood pressure can be deadly if not adequately treated. Unfortunately, many persons with hypertension do not seek treatment until complications develop, because they don't have symptoms and in some cases are unaware they have the disease," said Jonathan E. Fielding, MD, director of public health and county health officer. "Hypertension increases a person's risk for having a heart attack, heart failure or stroke, and can also lead to kidney failure, vision loss and dementia."

Public health officials emphasize that appropriate treatment of high blood pressure greatly reduces the risk for complications. Unfortunately, among many Angelenos, hypertension remains poorly controlled. The L.A. County Health Survey shows that hypertensive adults without health insurance or a regular source of care often go without blood pressure medication. In order for these patients to be able to control their blood pressure, it is essential that they have ongoing access to a regular source of healthcare and to affordable prescription medications.

Lifestyle factors also play a major role in the development and control of hypertension. "Our findings also show an important connection between someone having hypertension and their level of physical activity, alcohol use and obesity. These findings underscore the importance of efforts to help people adopt and maintain a healthy lifestyle, including eating a balanced diet, exercising regularly, limiting alcohol consumption and not smoking," said Fielding.

Among obese adults, 37 percent reported a past hypertension diagnosis, compared to 24 percent of overweight and 17 percent of normal weight adults.

Among adults who reported minimal physical activity, 27 percent had been diagnosed with hypertension, compared with 21 percent who met physical activity guidelines. The report also found that the prevalence of hypertension decreased as household income increased.

Because obesity is strongly associated with high blood pressure, one explanation for the rising rate of hypertension among county adults is the obesity epidemic. From 1997 through 2005, the percent of obese adults in L.A. County increased from 14 percent to 21 percent. However, the observed increase in hypertension could also be due to improvements in blood pressure screening and diagnosis, or improved survival among patients with hypertension.

The report lists several recommendations for individuals to prevent the risks of hypertension:

•See a regular healthcare provider and get blood pressure checked.

•Eat a healthy diet of food that includes at least four servings each of fruits and vegetables, and two servings each of daily lowfat dairy foods and whole grains.

•Limit salt and sodium intake.

•Limit alcohol consumption to no more than two drinks daily for men and no more than one drink daily for women.

•Engage in at least 30 minutes of moderate daily physical activity.

•Stop smoking.

The report also recommends the following for businesses, cities and communities:

•Make affordable, healthy foods and snacks more readily available in local markets and food stands.

•Encourage restaurants to provide nutritional information on the menus.

•Make communities more walkable by adding sidewalks, jogging trails and bike paths.

•Encourage after-school physical activities and support health promotion activities at work sites.

•Expand community outreach for increased access to healthcare services for the uninsured.

•Support public policies to encourage businesses to provide employees with health insurance.

A copy of the report is available at lapublichealth.org/ha.