Many Americans have blood pressure problems, but many are doing nothing to address them, according to research published today.

Scientists studied nationally representative data from Americans over the age of 20. Almost 80% of people with hypertension do not have it under control, they found; even worse, most people with uncontrolled hypertension do not take any blood pressure-lowering medications. The findings suggest that these drugs could have a major positive impact on the cardiovascular health of Americans, the researchers said—as long as they are able or willing to accept treatment.

“Many can achieve (blood pressure) control with initiation of antihypertensive medication and lifestyle changes,” they wrote in their paper, PUBLISHED Monday in JAMA.

Silent but deadly

Hypertension is defined as having a systolic blood pressure of 140 mm Hg or more (the top number in the blood pressure reading) and a diastolic blood pressure of 90 mm Hg or more (the bottom number). It is considered uncontrolled if the condition is not treated or the blood pressure remains high despite treatment.

High blood pressure by itself usually does not cause visible symptoms. But over time, it can increase the risk of other life-threatening conditions such as heart attack, stroke, and kidney disease, especially if not managed properly. According to the Centers for Disease Control and Prevention, hypertension contributed to 664,470 American deaths in 2023.

The American Heart Association recommends using a combination of lifestyle changes and medication to lower blood pressure in people with hypertension below 130/80 (such changes may include reducing sodium in your diet). The researchers wanted to know how many Americans didn’t meet that goal and why, so they analyzed data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative poll of Americans’ dietary and lifestyle habits run by the CDC.

Between 2021 and 2023, 47% of Americans will have hypertension, based on NHANES data. In those years, 79% of people with hypertension had uncontrolled blood pressure, the researchers found. Of those with uncontrolled blood pressure, nearly two-thirds (61%) reported not being on medication.

The good and bad news

While it is possible that some people will have hypertension despite treatment, greater adoption across the country will certainly move the needle. Two-thirds of people with uncontrolled blood pressure were within 10 points of the recommended goal, the researchers noted, indicating that many could reach it with enough help. And it looks like there are ways to start bridging that gap.

Although the majority of people with untreated hypertension have health insurance or a regular place to get health care (more than 80%), for example, their claim rates are lower compared to people with controlled hypertension. For others, it may be something to be aware of. A 2024 study found that 40% of Americans with hypertension don’t even know they have it, while most Americans do struggle to understand what their blood pressure reading means.

If you suspect you may have hypertension, or even if you haven’t had your blood pressure checked in a while, it’s probably worth making sure you get screened for it at your next doctor’s visit.