Study on high blood pressure finds high prevalence, low awareness and treatment disparities

A new study by researchers at the Irish Longitudinal Study on Ageing (TILDA) in Trinity College Dublin has raised a number of concerning findings at every stage of the hypertension health continuum for older adults in Ireland including high prevalence, lack of awareness, poor control despite treatment and disparities in treatment related to possession of a medical card. The key findings from the paper which has just been published in the Journal of Public Health include:

Older adults with no medical card were significantly less likely to be on medication to control their blood pressure, compared to those who did have a medical card.

Almost half of those who were on medication to control hypertension did not actually have their blood pressure controlled to normal levels.

• 45% of those with high blood pressure were unaware of their condition. Lack of awareness was higher in males and in the youngest group examined (50-64 years). This is the first comprehensive study in Ireland showing levels of awareness in this age group. The USA and Canada are leaders in awareness where 81% and 83% respectively of 20-79 year olds are aware of their hypertensive status.
• 64% of the over 50s in Ireland have high blood pressure, equivalent to 797,000 people. Previous figures from a much smaller scale study in 2007 of people over 45 gave this figure as 60%.
• In those with high blood pressure, 59% were taking medication to reduce it.

High blood pressure is a leading cause of heart disease, stroke, kidney failure and premature death and disability. It is considered to be responsible for 45% of ischaemic heart disease and 51% of total stroke mortality globally.

Commenting on the study, lead author, Dr Catriona Murphy, Research Fellow at TILDA in Trinity College Dublin said "The findings of this study are of concern as high blood pressure is usually a silent condition with no symptoms until it has caused damage to organs such as the heart or kidneys. The study results are consistent with this silent profile. The level of awareness we found in this Irish study is a combination of individual lack of awareness of the condition and the absence of a comprehensive system to detect this important risk factor in the community."

Dr Murphy continued: "In addition, the finding that respondents with no medical card were less likely to have their blood pressure treated suggests that policy directed towards reducing the financial barrier to healthcare and medication has the potential to impact positively on the long-term management of high blood pressure in Ireland."

Principal Investigator of TILDA, Professor Rose Anne Kenny commented "The high prevalence of high blood pressure is a major public health challenge for Irish society and requires a population wide focus on healthier lifestyles including weight management, regular physical activity, smoking cessation and restriction of salt and alcohol intake. This study calls for action to implement a structured programme in primary care to improve prevention, detection and management of high blood pressure in Ireland."

Dr Angie Brown Medical Director of the Irish Heart Foundation and study collaborator said "This important research highlights what we (the Irish Heart Foundation) see on our Blood pressure road show and during our health assessments. High blood pressure is often unrecognised and even if diagnosed sometimes not adequately treated. It is crucial that we raise awareness of this silent killer so individuals know their own blood pressure, the importance of lifestyle modification and adherence to medical therapy if appropriate. The good news is this is an entirely treatable risk factor."