Arterial hypertension affects forty-four percent of Italian men aged thirty-five to seventy-four, leaving millions at high risk for heart attacks and strokes.
Corriere della sera reported these figures from the Italian Health Examination Survey conducted by the Istituto Superiore di Sanità, highlighting a widespread failure in diagnosis and treatment continuity. The data shows that thirty-six percent of men and twenty-eight percent of women with high blood pressure go undiagnosed. About fifteen percent of individuals with documented hypertension take no medication at all.
Patients who already have cardiovascular disease often fail to reach safe pressure targets. Recent findings from the Bring-Up Prevenzione study, conducted by the Associazione nazionale Medici Cardiologi Ospedalieri, show that fewer than forty percent of heart patients achieve adequate blood pressure levels for their risk category.
European Society of Cardiology guidelines recommend a systolic reading between 120 and 129 mmHg for almost all adults.
Real-world management falls short of these goals due to late diagnoses, complex drug regimens, and low treatment persistence. Italian Medicines Agency data confirms that nearly half of all patients do not take their prescribed medications consistently.
Professors discussed these treatment gaps during the Il Tempo della Salute event.
“It is a topic that has fallen into a shadow,” said Furio Colivicchi, president of the Fondazione Anmco Per il Cuore, vice-president of the Federazione Italiana Società Medico-Scientifiche, and director of clinical and rehabilitative cardiology at San Filippo Neri Hospital in Rome, told Corriere della sera. “We have forgotten about it somewhat, but we must consider that almost all hospitalized cardiac patients have blood pressure that is too high.”
Hypertension increases risks of heart failure and systemic inflammation
High blood pressure stiffens arterial walls, which worsens pressure values and increases systemic inflammation. This physiological cascade raises the risk of heart failure, arrhythmias, ischemia, strokes, cognitive decline, kidney damage, retinopathy, and erectile dysfunction.
“The damage from hypertension is innumerable,” Fabrizio Oliva, director of the clinical cardiology department at Niguarda Hospital in Milan and president of the Italian Federation of Cardiology, told Corriere della sera.
High blood pressure also promotes cholesterol accumulation.
Colivicchi said that smoking acts as an additive risk factor that accelerates cardiovascular danger exponentially.
Medical consensus centers on the systolic reading, or the maximum pressure value, as the primary indicator of cardiovascular strain.
The threshold to avoid is 130 mmHg, while 120 over 80 mmHg marks the limit of normal blood pressure.
“A separate case regarding normal values concerns the elderly,” Colivicchi specified to Corriere della sera. “To decide the optimal value to aim for, we must look at comorbidities and personalize the indication.”
Exercise and salt reduction improve blood pressure
First-line interventions focus on physical activity and dietary adjustments. Oliva recommended one hundred and fifty minutes of moderate aerobic exercise weekly, such as brisk walking, swimming, or cycling, or seventy-five minutes of intense activity.
Diets should limit daily salt intake to five grams. Processed foods, cured meats, prepared meals, sauces, and certain breads contain high sodium levels.
“In Italy, the average intake is higher: seven to nine grams for men and only a little less for women,” Oliva told Corriere della sera. “Check the labels. And where you read ‘sodium,’ it must be multiplied by 2.5.”
Body weight reduction directly lowers blood pressure. Losing one kilogram reduces systolic pressure by approximately one mmHg, mitigating the inflammatory effects of visceral obesity.
When medication becomes necessary, physicians select from numerous drugs with proven safety and efficacy profiles.
“There are now dozens of drugs with excellent safety and efficacy profiles, also on future prognosis,” Colivicchi indicated to Corriere della sera. “To be taken preferably in the morning.”
Patients can monitor their blood pressure at home using standard upper-arm digital devices.
Smartwatch measurements lack sufficient validation data for clinical diagnosis.
“It is fine at home, with devices, even arm cuffs,” Oliva told Corriere della sera. “It is necessary to be seated with the arm at body height, bare, and to do it in peace, three measurements in a row. Do not do it continuously because it agitates. The final evaluation must then be made by the specialist.”
Common patient questions about blood pressure
What blood pressure reading requires immediate lifestyle changes?
Readings at 140 mmHg require intervention, beginning with lifestyle modifications such as increased aerobic exercise and strict dietary sodium reduction.
Why do cardiovascular patients struggle to reach target blood pressure?
Treatment gaps are driven by late diagnoses, insufficient medication adjustments by physicians, complex drug schedules, and poor patient persistence with prescribed therapies.
How should patients properly measure blood pressure at home?
Patients should take three consecutive measurements while seated in a quiet room with a bare arm supported at heart height using an upper-arm cuff device.