A new study suggests that American men are much more likely than women are to be unaware that they suffer from hypertension (high blood pressure). African-American men with hypertension (high blood pressure) are at the highest risk, with only one in seven both aware of their illness and able to control it through medication.

“The explanation of the disparity, while not clear, isn’t closely associated with perceived discrimination at the doctor’s office, which is a good thing,” said study lead author Ronald Victor, M.D. “The differences also don’t appear to be associated with lack of knowledge about hypertension (high blood pressure).”

Instead, other factors appear to be at work. Both whites and African-Americans who think they are in good health are especially likely to fail to treat their hypertension (high blood pressure) or even realize they have hypertension (high blood pressure), said Victor, chief of the hypertension (high blood pressure) division at University of Texas Southwestern Medical Center in Dallas.

Researchers have long known that African-Americans are at higher risk of developing high blood pressure, also known as hypertension, Victor said.

The condition can lead to a variety of ills, including heart disease, heart failure, kidney (renal) disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage and stroke (brain damage).  Still, many have long referred to hypertension (high blood pressure) as the “silent killer” because it often has no outward symptoms.

In the new study, designed to examine the causes of the racial disparity, researchers interviewed 1,194 African-American and 320 white adults from the Dallas area and took consecutive measurements of their blood pressures between 2000 and 2002. No Latinos or members of other racial groups took part in the study.

Compared to those without regular doctors, study participants who had a regular physician were almost four times more likely to be aware of their hypertension (high blood pressure), eight times more likely to undergo related treatment and five times more likely to have the condition under control.

Among people with hypertension (high blood pressure), those who believed they were healthy were “one-third as likely to know they’ve got hypertension (high blood pressure), half as likely to be treated and two-thirds as likely to have their blood pressure controlled” compared to those who did not believe they were healthy, Victor said.

Among both sexes and races, African-American women with hypertension were the most likely to know they had hypertension (high blood pressure), Victor said. Eighty percent of them were aware, and a third had their condition under control.

The findings make sense to Dawn Wilson, a professor of psychology at the University of South Carolina who studies hypertension (high blood pressure).

Ethnic minorities and the poor often have misperceptions about the health-care system and might actually be aware that they are unhealthy, but deny it because they do not have enough money, she said.

Study author Victor suggested doing more to educate men about the importance of regular health checkups. “There’s no such thing as a ‘well-man’ exam, and maybe that’s the issue,” he said. “In our society, women learn to become health conscious in terms of preventive health care, and men don’t have that kind of emphasis from a young age.”

Archives of Internal Medicine. Contact: Media Relations at (312) 464- 5262 or This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Victor RG, et al. Factors associated with hypertension awareness, treatment, and control in Dallas County, Texas. Arch Intern Med 168(12), 2008.

Interviews: Ronald Victor at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

The study appears in the June 23 issue of the Archives of Internal Medicine.
 

About Hypertension (High Blood Pressure)

High blood pressure (hbp) or hypertension means high pressure (tension) in the arteries. Arteries are vessels that carry blood from the pumping heart to all the tissues and organs of the body.

Currently it is estimated that nearly 73 million adults in the United States have high blood pressure.  Affecting approximately one in four adults in the United States, hypertension is clearly a major public health problem.

Hypertension, which is one of the major modifiable risk factors for cardiovascular disease, can lead to heart disease, heart failure, kidney (renal) disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage and stroke (brain damage). These complications of hypertension are often referred to as end-organ damage because damage to these organs is the end result of chronic (long duration) high blood pressure (hypertension)”.  For this reason, the diagnosis of high blood pressure (hypertension)” is important so efforts can be made to normalize blood pressure and prevent complications

Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called "pre-hypertension", and a blood pressure of 140/90 or above is considered high.

The top number, the systolic blood pressure, corresponds to the pressure in the arteries as the heart contracts and pumps blood forward into the arteries. The bottom number, the diastolic pressure, represents the pressure in the arteries as the heart relaxes after the contraction. The diastolic pressure reflects the lowest pressure to which the arteries are exposed. Note: It was previously thought that rises in diastolic blood pressure were a more important risk factor than systolic elevations, but it is now known that in people 50 years or older systolic hypertension represents a greater risk.