Knowledge Gaps on Hypertension Underscore Need for Clearer Clinician Guidance

A survey conducted through the University of Pennsylvania’s Annenberg Public Policy Center found that many people lack general knowledge of hypertension.1

“If you don’t know what it means to have high blood pressure or why it’s a problem or how you can prevent it, you might not realize that you have a problem that you could correct,” said Kathleen Hall Jamieson, PhD, the center’s director, in an interview with JAMA Medical News.

Hypertension is often asymptomatic and may go unrecognized if at-risk patients are not screened.2Those at risk include patients with pretension and diabetes, as well as those who are obese, smoke tobacco, drink excess alcohol, have a diet high in sodium and low in potassium, and live a sedentary lifestyle.

The April 2025 survey included 1653 US adults, of whom 35% had hypertension, 10% had prehypertension, and 2% had gestational hypertension.1 Among respondents with hypertension, only two-thirds reported being somewhat or very worried about it, and 5% reported being not worried at all. Only less than 20% of respondents reported being very worried about their hypertension.

Even though nearly 50% of participants reported being somewhat worried about their condition, only 13% of respondents correctly identified a blood pressure reading of≥ 130/80 mmHg as the threshold for hypertension.1

A quarter of participants (25%) believed that 140/90 mmHg was the defining measurement for hypertension. However, this used to be the cutoff before the American Heart Association (AHA) and the American College of Cardiology reduced it in 2017. Roughly a quarter of participants did not know the cutoff was lowered (24%), and the rest of the respondents selected incorrect cutoffs, such as over 120/70 (4%), over 130/90 (18%), and over 140/80 (16%).1

The survey also revealed that many people do not realize that an increased blood pressure does not always lead to noticeable symptoms (37%). More than a third of participants believed that hypertension would result in symptoms of dizziness and shortness of breath. 1

Additionally, 2 in 5 of the respondents thought that feeling calm and relaxed indicated a normal blood pressure. To the statement “feeling calm and relaxed is an indication that your BP is in the normal range,” 30% put probably true, 8% put definitely true, and 17% put not true.1

Although the survey showed many people do not know how to define hypertension, many respondents reported knowing how to lower blood pressure, including maintaining a healthy weight (91%), regularly exercising (89%), eating nutritious foods (89%), and reducing salt intake (82%). Most participants could identify false statements, except 3% thought drinking coffee and 2% thought drinking alcohol could reduce blood pressure.1

However, 4 of 5 people reported that they would be likely to take steps to lower blood pressure if advised by a clinician.1 Few people with hypertension reported that they consistently followed through on these recommendations.

Only 61% of respondents participated in physical activity more than once a week, and 19% rarely or never exercised. About 73% tried to eat nutritious meals more than once a week, and 69% tried to limit salt intake. Nearly a quarter of participants (23%) rarely or never considered cutting down on sodium.1

The AHA recommends regular at-home blood pressure monitoring, and yet, the survey found only 22% with hypertension checked their own blood pressure more than once a week; 10% checked it almost never. Moreover, 13% of respondents with hypertension had never checked their blood pressure at home.1

Respondents had high adherence to blood pressure medication, with 90% taking it daily or nearly daily. For respondents who did not take the medication daily, reasons for it included not thinking it was necessary to do it every day (36%), feeling okay without it (28%), forgetting (19%), adverse events (16%), and the cost (14%).1

“We need to find a way to get useful health information where we need it and can act on it,” Jamieson said.1 “That increases salience, it increases retention, increases the likelihood we’ll use the knowledge.”

The survey emphasizes the importance of clinicians communicating with their patients about what hypertension is, how to look out for it, and how to manage the condition. Jamieson suggested a small modification, such as removing saltshakers from restaurant tables.1

“We need to increase the likelihood that I’ll act in ways that are consistent with the knowledge that I have,” Jamieson added.1

References

1. Anderer S, Rekito A. Hypertension Survey Finds Many US Adults Lack Key Knowledge of the Condition. JAMA. Published online August 15, 2025. doi:10.1001/jama.2025.13589

2. Managing patients with hypertension: Tips and strategies to improve the care you provide your hypertensive patients. HCPLive. May 20, 2015. https://www.hcplive.com/view/managing-patients-hypertension-tips-and-strategies-improve-care-you-provide-your-hypertensive. Accessed August 19, 2025.