Posted: 2/8/2016
One-third of Americans have hypertension, may not know it
It can damage your body for years without causing any symptoms. Or you may have mild symptoms that go unrecognized. Either way, it might be slowly killing you, cardiologists say.
“Hypertension is a silent killer,” said Shawna Nesbitt, MD, Medical Director of the Hypertension Clinic at Parkland Health & Hospital System and Associate Professor of Internal Medicine - Hypertension, University of Texas Southwestern Medical Center. “Unfortunately, most people don’t have symptoms they recognize. For example, they might have frequent mild headaches but not know hypertension is the cause unless they get their blood pressure checked.”
During Heart Month in February, Parkland experts are urging everyone to “know their numbers,” including their total cholesterol, glucose, body mass index (BMI) and blood pressure numbers. As many as 80 million adults in the U.S. – one in three – have hypertension, or high blood pressure, a condition that can lead to cardiac disease, stroke and death and may also play a key role in kidney disease, cognitive function and dementia.
Even if you have been paying attention to your blood pressure numbers, a major new study by the National Institutes of Health released in November found that recommendations doctors have given patients for years about blood pressure management weren’t aggressive enough.
“The Systolic Blood Pressure Intervention Trial (SPRINT) was a landmark clinical trial that has really been a game-changer in terms of target blood pressure,” Dr. Nesbitt said. “Until now, we thought that a level of 140/90 was adequate, but this study conclusively answered a question cardiologists have debated for decades: how low should blood pressure go? The answer is, much lower than we thought.”
The study found that patients who were assigned to reach a systolic blood pressure goal below 120 — far lower than current guidelines of 140, and 150 for people over 60 — had their risk of heart attacks and strokes reduced by nearly a third and their risk of death reduced by nearly a quarter. As a result, the American Heart Association is considering the results of the SPRINT trial to decide on the specific changes to guidelines and blood pressure goals. A healthy blood pressure is 120/80. Some groups like elderly and patients with kidney disease may have different goals to ensure safety.
The systolic blood pressure, the top number in the blood pressure measurement, refers to the pressure the heart must generate to pump blood to the rest of the body. The diastolic or bottom number in the measurement represents the pressure that the heart must generate to counteract the existing pressure in the body’s blood vessels
Dr. Nesbitt said both heredity and lifestyle influence blood pressure. “The likelihood that you’ll have hypertension if your parents had it is quite high,” she said. “African Americans and Hispanics are at greater risk than whites. It’s even more important for us to screen these high risk populations early to possibly head off the disease.”
Age, tobacco use, diet and other lifestyle factors also play a significant role.
“There are many things people can do to lower their blood pressure and lower their risk of heart attack and stroke,” Dr. Nesbitt said. Among them:
- Eating a healthier diet with less salt
- Exercising regularly
- Quitting smoking
- Managing stress
- Limiting the amount of alcohol you drink
- Maintaining a healthy weight or losing weight if you're overweight or obese
- Monitoring your blood pressure at home
“I recommend that my patients eat more fruits and vegetables because they provide calcium and potassium that help regulate and lower blood pressure. It’s also highly beneficial to exercise at least 30 minutes per day four times a week, or 10 to 15 minutes daily.”
For patients requiring medication to help lower blood pressure, Dr. Nesbitt said there are many good options available. “The important thing is to get your blood pressure checked regularly. Your doctor can help you decide what mechanisms are best for you to help lower your blood pressure if you have hypertension.”
For more information about high blood pressure, visit www.heart.org.