The Blue Cross Blue Shield Health IndexSM is a valuable resource. This health metric uses de-identified claims data collected from a commercially insured population to determine the health conditions with the most significant impact on the American population. The data can be drilled down to the state or county level.
According to this index, although major depression (10.1 percent), high cholesterol (8.1 percent), and coronary disease (6.5 percent) are worthy runner ups, hypertension (12.5 percent) takes the cake for Kansans, as well as Americans. The data indicates hypertension is responsible for more adverse health impact than any other health condition.
Hypertension begins silently. Usually at onset it creates no symptoms, but lurks and creeps for years. It may be detected on a routine health assessment, but commonly can be brushed off as “white coat hypertension” or just a bad day. As the years go by, vascular damage accumulates. The “silent killer” may then rear its ugly head and begin speaking when one is abruptly awakened in the middle of the night clutching his/her chest with cardiac pain or found down by a loved one, disabled by sudden and catastrophic neurologic injury from stroke. Unfortunately, at this stage the damage has been done, often with limited treatment options or recourse. Those impacted are frequently left asking, “Why didn’t I do something to prevent this?”
Genetics, metabolic abnormalities, sedentary lifestyle, diet, aging and many other possible factors may contribute to hypertension.
Fortunately, much can be done to treat hypertension and prevent potential adverse outcomes. Lifestyle modification is always the starting point for treatment. However, hypertension is progressive, and often will ultimately require medication. Many options exist for pharmacologic management. Most of the medications are well tolerated, and less costly generic options are widely available. As hypertension is silent, so is the treatment of hypertension. I can recall many patients who resisted medications as it did not make them feel any different or better. As a provider for a reluctant patient, sometimes your only motivating response is to inform him/her that you do not want the next visit to be an unexpected trip to the hospital where the “Why didn’t I do something to prevent this?” question is again asked.
The data has spoken.
Normal adults should be screened for hypertension annually, those with risks should be screened at least twice a year. Anyone diagnosed with hypertension needs to understand the seriousness of this health condition, as it is responsible for more adverse impact on health than any other health condition facing Kansans. I recommend developing a relationship with a primary care physician to help with the screening, diagnosis, monitoring and treatment of hypertension.
Kent Haverkamp, M.D., is board certified in both internal medicine and pediatrics. Prior to joining BCBSKS in 2013 as a medical director, Haverkamp worked for Cotton-O’Neil Clinic from 1993 to 2013 as a primary care provider for adult and pediatric patients.