High Blood Pressure in Hawaii

Hawaii

High blood pressure (or hypertension) is a major risk factor for heart disease and stroke, which are the leading and fifth-leading causes of death in the United States, respectively. In 2021, almost 700,000 deaths in the U.S. were caused by complications of hypertension.

High blood pressure often shows no signs or symptoms. Once diagnosed, however, it can be controlled through a combination of diet, exercise and medication. High blood pressure is influenced by risk factors that can be modified, such as smoking, obesity, physical inactivity, poor diet (eating foods high in sodium and low in potassium) and excessive alcohol use. 

In 2017-2018, the total cost of high blood pressure in the United States was $51.1 billion. By 2035, it is projected that the direct medical costs of high blood pressure could reach $154 billion.

According to America’s Health Rankings data, the prevalence of diagnosed high blood pressure is higher among:

• Men compared with women.
• Adults with less than a college degree; college graduates have the lowest prevalence of high blood pressure. 
• Adults ages 65 and older compared with younger adults.
• Adults with an annual household income less than $25,000 compared with those with higher levels of income. 
• Adults living in non-metropolitan areas compared with adults living in metropolitan areas.

Other populations with a higher prevalence of high blood pressure include:

• Black adults compared with white and Asian adults. Research suggests that racial and ethnic disparities in blood pressure prevalence is likely due to stress caused by social and economic factors, such as racism, rather than biological differences. Additionally, Black adults are more likely to develop high blood pressure at a younger age than white adults.

High blood pressure is an ideal target for prevention and control strategies, as it can be changed through lifestyle modification and health care interventions. Individuals can reduce their risk of developing or manage existing hypertension by:

• Reducing dietary sodium intake. 
• Increasing physical activity.
• Quitting smoking.
• Taking blood pressure medication as prescribed by their health care provider.
• Getting screened every two years or as suggested by a doctor.
• Self-measured blood pressure monitoring for convenient and accessible blood pressure control.

Interventions promoting education and treatment for high-risk populations, such as barbershop interventions for Black men, have been shown to be effective and sustainable. Improving care coordination for rural and medically underserved areas can help patients access medications and use them correctly. This could be accomplished by encouraging community health workers to establish partnerships with medication therapy management programs to improve medication adherence efforts among patients.

Healthy People 2030 has multiple cardiovascular health objectives, including reducing the proportion of adults with high blood pressure and increasing control of high blood pressure in adults.

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“Cardiovascular Disease: A Costly Burden for America — Projections Through 2035.” American Heart Association CVD Burden Report. Washington, D.C.: American Heart Association, 2017. https://www.heart.org/-/media/files/get-involved/advocacy/burden-report-consumer-report.pdf.

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Victor Ronald G., Blyler Ciantel A., Li Ning, Lynch Kathleen, Moy Norma B., Rashid Mohamad, Chang L. Cindy, et al. “Sustainability of Blood Pressure Reduction in Black Barbershops.” Circulation 139, no. 1 (January 2, 2019): 10–19. https://doi.org/10.1161/CIRCULATIONAHA.118.038165.