Hypertension Education Foundation Survey Results Announced At American Society For Hypertension Annual Meeting Suggests ImprovedControl Of High Blood Pressure, But Misconceptions Still ExistFindings Show Compliance with Medication Instructions but Underscore Need for Improved Patient Communication, Lifestyle Management and More Healthcare Provider Efforts to Control Elevated Blood Pressure
NEW YORK, May 19, 2007 /PRNewswire/ -- Results of a survey conducted by Harris Interactive(R) for the Hypertension Education Foundation (HEF) were presented at the American Society of Hypertension, Inc. (ASH) Twenty-Second Annual Scientific Meeting and Exposition (ASH 2007) in Chicago and published in the May issue of The Journal of Clinical Hypertension. The survey suggests encouraging progress in controlling hypertension, also known as high blood pressure (HBP). There remains a disconnect, however, between knowledge of what should be done, such as following physician recommendations about treatment and lifestyle management, and the actions American adults are taking to manage HBP and the risk factors associated with it.
"Effective management of hypertension and the decrease in strokes and cardiovascular events provide a dramatic example of successful disease prevention," says Dr. Marvin Moser, president of the HEF. "Results of this survey indicate that nine out of ten people that have been diagnosed with high blood pressure are on some medication to control it. This is encouraging, but we have a long way to go since blood pressure is not controlled at goal levels in many of them. Our findings highlight several points, including the following: misconceptions regarding high blood pressure, the need for better patient communication, and evidence indicating that many adult Americans have not altered their lifestyle to help prevent the complications of hypertension."
Nearly 60 million American adults have HBP; it has been estimated that about one-third of them do not know they have the condition because it is associated with few symptoms. High blood pressure is a primary or contributing cause of death for over 250,000 people in the US annually and it is the most common reason that adults see physicians, according to a 2004 report by the U.S. Department of Health and Human Services, National Institutes of Health and National Heart, Lung and, Blood Institute. It is a significant risk factor for coronary heart disease, stroke, and heart and kidney failure. When combined with other conditions, such as an elevated cholesterol level or diabetes, HBP significantly increases chances of a cardiovascular event. The good news, Dr. Moser notes, is that lowering blood pressure (BP) over time will result in decreases of between 35 and 50% in these complications.
The not so good news, according to the survey findings, is that at least one-third (36%) of patients taking medication had BPs higher than 140/90 mm Hg (the present goal for the general public), the last time they had it checked. (An additional 14% were not sure what their BP was the last time they had it checked.) Although this percentage is considerably lower than in previous surveys, half of the respondents (50%) report that they were told by their physician that their blood pressure was too high at some point since they began taking medication. These results cannot be directly compared to previous surveys since they represent respondents' answers and not the results of patient examinations. Approximately one-third (31%) of those who were told that their BP was still too high after they began to take medication were told by their healthcare provider to keep taking the same medication. This finding is consistent with other studies.
The survey, which was supported by a grant from King Pharmaceuticals, Inc., polled 1,245 adults age 45+ who have been diagnosed with HBP. The survey suggests that most people with HBP understand the risks associated with it and recognize what they might have to do to help control it. At least nine out of ten (91%) people surveyed are aware that losing excess weight and regularly exercising help control hypertension and more than 90% of survey respondents (correctly) associate HBP with an increased risk of heart attack (94%) and stroke (93%). In addition, many survey respondents are aware that HBP increases the risk of other life-threatening conditions such as failure of the kidney to function properly (61%), hardening of the arteries (65%) or enlarged heart (61%). This degree of awareness of the risks associated with hypertension is considerably higher than it was several years ago.
"Most Americans have become more aware of hypertension and its risks," notes Dr. Moser, who is a Clinical Professor of Medicine at Yale University School of Medicine and Editor-in-Chief of The Journal of Clinical Hypertension. "Knowing about risks is important, but controlling them may be difficult because there are few compelling or immediate incentives to take medication or change habits because of the lack of annoying symptoms from high blood pressure."
Responses to the survey indicate that general practitioners are the primary source of information for nearly two out of three respondents (65%), and that 91% of people diagnosed with HBP were prescribed medication to manage the disease. While the majority of respondents (56%) are aware of their treatment goal, and over half received educational materials explaining the risks associated with HBP from their healthcare provider, the significant percentage that were unaware of their treatment goals or did not receive educational materials (42%) indicates a need for better communication. Additionally, more than a third (36%) of respondents were not told, or were not sure if they were told, by their healthcare provider of the cardiovascular risks that might be associated with high blood pressure.
"The kind of information the patient receives from a doctor can affect a patient's ability to control his/her high blood pressure," notes Dr. Moser. "While it is not possible to tell from the survey whether the communication gap is a problem with the patient or the physician, what is clear is that some important messages about high blood pressure are not getting through to enough patients."
The survey reveals the prevalence of some ongoing misunderstandings about hypertension, and highlights that some misperceptions were more prevalent in certain ethnic groups than others. For example, nearly a quarter (22%) of African-American survey respondents held the belief that HBP means that a person is tense or anxious, compared to only 10% of Caucasian and 17% of Hispanic respondents. In addition, African-Americans were also more likely than Hispanics or Caucasians to believe that hypertension is less of a problem among older adults.
Other misperceptions cut across all demographic groups. For example, 25% of survey respondents incorrectly believe weight loss alone is enough to cure HBP/hypertension. In fact, although this was in general a widely-held misperception, the HEF survey showed that it is a more commonly held perception among people with incomes of $75,000 or more (31%).
"Misperceptions indicate the need for more education," observes Dr. Moser. "People's understanding -- or misunderstandings -- about high blood pressure are key factors in what they do or do not do to try to manage it. It is, therefore, important that a patient's knowledge base be as accurate as possible."
Lifestyle Choices Reflect Lack of "Actionable Concern" for HBP Risk
While the survey suggests that many respondents understand that certain lifestyle adjustments need to be made to help control HBP, a majority of patients indicate that they are not complying with important lifestyle management issues such as diet and exercise.
Though nearly all (91%) respondents agree that losing excess weight and doing regular exercise helps control HBP, only 42% report actually exercising regularly. In addition, over a third of respondents report that they do not follow a healthy diet (38%) or limit salt intake (38%). Many respondents cite that simply taking medication eliminates the need to manage such lifestyle factors.
"It appears that there is enough concern among individuals diagnosed with high blood pressure to visit their doctor routinely and take their medicine, but not enough concern to motivate them to change his/her daily activities to optimally control their blood pressure," says Dr. Moser. "Although there is evidence of a higher percentage of control than has been reported in other national and local surveys, the survey findings here highlight that there is still a need for improvement, both on the part of patients and providers of health care."
This survey was conducted online within the United States by Harris Interactive on behalf of the Hypertension Education Foundation and King Pharmaceuticals, Inc. between January 4 and 17, 2007 among 1,245 adults, aged 45 and over, who have been diagnosed with hypertension. Figures for education, age, sex, race/ethnicity, region and household income were weighted where necessary to bring them into line with their actual proportions in the population. Propensity score weighting was also used to adjust for respondents' propensity to be online.
With a pure probability sample of 1,245 adults, one could say with a ninety-five percent probability that the overall results have a sampling error of +/- 3 percentage points. Sampling error for data based on sub-samples would be higher and would vary. However, that does not take other sources of error into account. This online survey is not based on a probability sample and therefore no theoretical sampling error can be calculated.
The Hypertension Education Foundation, Inc. (HEF) was incorporated as a public foundation in 1977 for the purpose of increasing both physician and public awareness of the problems of treating HBP and promoting research and teaching efforts in the field of hypertension. It has organized and participated in more than 50 hypertension symposia throughout the US over the past eight years and has sponsored Visiting Lecturers, Fellowships in hypertension, and other educational programs, as well as research into the causes of hypertension in different ethnic groups. The HEF distributes two educational booklets, "High Blood Pressure: What You Should Know About It and What You Can Do To Help Your Doctor Treat It" and "High Blood Pressure and Diabetes: Control Them and Live Longer."
About Harris Interactive
Harris Interactive is the 12th largest and fastest-growing market research firm in the world. The company provides innovative research, insights and strategic advice to help its clients make more confident decisions which lead to measurable and enduring improvements in performance. Harris Interactive is widely known for The Harris Poll, one of the longest running, independent opinion polls, and for pioneering online market research methods. The company has built what it believes to be the world's largest panel of survey respondents, the Harris Poll Online. Harris Interactive serves clients worldwide through its United States, Europe and Asia offices, its wholly-owned subsidiary Novatris in France, and through a global network of independent market research firms. The service bureau, HISB, provides its market research industry clients with mixed-mode data collection, panel development services, and syndicated and tracking research consultation.
Posted: May 2007