2 days ago
Are you among adults who don't know you have diabetes, hypertension?
A significant number of adults in the U.S. don't know that they have high blood pressure, diabetes or bad total cholesterol numbers, which all contribute to the risk of death from cardiovascular disease. And awareness may be even worse now because COVID-19 disrupted preventive screenings.
That's according to a new study in the journal JAMA Cardiology from researchers at Beth Israel Deaconess Medical Center, the Pritzker School of Medicine at the University of Chicago and the Harvard T.H. Chan School of Public Health.
The research involved 15,269 nonpregnant adults 20 or older (average age 56.8 years) who had cardiovascular risk factors between 2013 and 2023, using the National Health and Nutrition Examination Survey. The researchers looked specifically at how many didn't know their own health status for those conditions, which was learned through a household interview and then a medical examination.
'The proportion of U.S. adults who were unaware of having hypertension increased significantly over the study period, particularly in young adults and women, while diabetes and high cholesterol level unawareness remained stable. By the 2021 to 2023 cycle, approximately 1 in 6 adults with hypertension and 3 in 10 with diabetes were unaware of their condition,' per the study.
The adults who had been identified as having a cardiovascular risk factor but who reported not being told by a health professional that they had the factor were classified as unaware.
'Given declining cardiometabolic health in young adults,' the authors expressed concern that about one-third of those with hypertension, 2 in 5 with diabetes and 1 in 4 with high cholesterol are not aware of their own situation. They added that 'policy efforts to address these gaps in awareness are needed to prevent future cardiovascular events.'
The researchers found that across the entire age range studied, 17.8% who had hypertension didn't know it in 2021-2023, compared to 14.6% in 2013-2014. The proportion of adults who didn't know they had diabetes did not change significantly, going from 27.5% to 28.9%. The share with high cholesterol who didn't know was also stable, at 11.5% and 11.9% respectively.
But age made a difference. The proportion of young adults ages 20-44 who didn't know they had hypertension rose from 21.9% to 37.1%. Awareness of that didn't change for those 45 and older, or among different age groups who had undiagnosed diabetes or high cholesterol.
Lack of awareness of having high blood pressure rose significantly over the study period in women, to 16.5%.
All three of those conditions are treatable. Left untreated, however, they can cause severe problems or kill. They are considered 'modifiable risk factors' for cardiovascular disease.
The Centers for Disease Control and Prevention reports that heart disease is the leading cause of death in the United States. It includes stroke, heart failure and atrial fibrillation.
High cholesterol can lead to a buildup of plaque on artery walls, narrowing those blood vessels and limiting or blocking blood flow to and from the heart and other organs, per CDC. That can cause chest pain or a heart attack. It also raises the risk for heart disease and stroke, which are leading causes of death.
High blood pressure or hypertension doesn't usually have symptoms, but can damage the heart, brain, kidneys and eyes. Making lifestyle changes or taking blood pressure medicines can reduce the risk, per CDC.
People who have diabetes have twice the risk of heart disease and the risk climbs over time. High blood sugar damages blood vessels and the nerves that control the heart, per CDC. But medication and lifestyle changes can help there, too.
Those with diabetes are also more apt to have high blood pressure and so-called 'bad' cholesterol — along with the increased risk those conditions bring. They are also more likely to experience heart failure, where the heart pumps less efficiently, which can also lead to a buildup of fluid in the lungs, making breathing both miserable and difficult.
Cleveland Clinic reports that about half of U.S. adults have some form of cardiovascular disease and that 1 in 3 women die from it.
Among the risk factors — besides hypertension, high cholesterol and type 2 diabetes — are tobacco use including vaping, genetics, lack of exercise, an unhealthy diet, overuse of alcohol, misuse of prescription and recreational drugs, some chronic autoimmune or inflammatory conditions, chronic kidney disease, and certain pregnancy-related complications.
As reported by Medical News Today, researchers at the University of Copenhagen in Denmark found that those who don't know they have forms of heart disease and who have undetected obstructive coronary atherosclerosis have an eight-fold risk of heart attack.
That same study suggested that nearly half of adults over 40 'may have such 'hidden' heart conditions.'
The American Heart Association noted that there are other conditions that often go undiagnosed, including a 'potentially fatal buildup of abnormal proteins in the heart and other organs.' That condition, called transthyretin amyloidosis, is considered rare, but studies now suggest that it's a fairly common cause of heart failure in older adults, with the proteins found in the hearts of one-fourth of older adults at autopsy.
That condition, like hypertension, diabetes and high cholesterol, is also treatable. But it has to be diagnosed and addressed.
Undiagnosed heart disease is also responsible for a very large share of heart attacks that aren't caused directly by a blood clot, the association separately reported.
