High blood pressure (hypertension) is one of the leading contributors to death here in the United States. According to the CDC, about 75 million people, or one out of three adults have hypertension. Unfortunately, only about half of the population with hypertension have their high blood pressure under control. If your blood pressure is not controlled, you are four times more likely to die from a stroke and three times more likely to die from heart disease. In fact, 69% of people who have their first heart attack, 77% who have their first stroke and 74% with chronic heart failure all have high blood pressure. As well, hypertension is not just an “old folks” disease. An American Academy of Pediatrics study shows that up to 15% of teenagers may have either elevated blood pressures or outright hypertension.
Blood pressure measures the force of your blood inside your arteries. The top number (systolic) is the pressure when your heart contracts, and the bottom number (diastolic) is the pressure when relaxed. If your systolic measures 120 and diastolic measures 80, the reading is “120 over 80”, or written, 120/80 mmHg. The CDC guidelines provide “normal” blood pressure as systolic less than 120 and diastolic less than 80, “pre-hypertension” (at risk for hypertension) as systolic 120-139 and diastolic 80-89, and “high” as systolic 140 or higher and diastolic as 90 or higher.
Lifestyle choices may have significant influence on blood pressure. A diet that is too high in sodium or low in potassium may put you at risk. Sodium is the element in table salt that raises your pressure and commonly comes from processed and restaurant food. About half of individuals who limit their salt intake may see a positive response in their blood pressure. Those low in potassium intake may want to include bananas, beans, yogurt and potatoes in their daily diet. Individuals who are overweight may likely see an increase of their blood pressure as their weight goes up. Increasing physical activity has many benefits, and weight loss can be one of them. However, losing weight may not guarantee lower blood pressure, as there are people who are not overweight who have hypertension. Drinking too much alcohol can raise blood pressure, and the CDC recommends women to have no more than one drink per day and men no more than two. Nicotine use includes cigarette smoking, chewing tobacco and vaping, all which increase heart rate and blood pressure as well as restrict blood flow to the heart, significantly increasing cardiovascular risk.
Hypertension is known as the “silent killer”, as you rarely feel the presence of high blood pressure. However, the effects of high pressure over time can damage circulation resulting in stroke, heart attack, heart failure, and kidney failure. Controlling blood pressure may include the previously mentioned lifestyle changes such as diet modifications, increasing activity/exercise levels and not smoking as first line therapies. Many of us will need the addition of some medication to reach adequate levels of control.
As February is American Heart Month, it is a good time to see if you are at risk. A simple blood pressure check is the first step to determine your risk. Your doctor’s office should readily be able to check your blood pressure on request. The health kiosks commonly seen at your pharmacy and grocery store are usually accurate for screening purposes. And most fire departments will be happy to check your blood pressure, as they are trained professionals and have the proper equipment to do so. Even if you have a normal blood pressure with one reading, do not stop there. Blood pressure will vary throughout the day, so additional checks at different times are important for consistent accuracy of screenings. The tendency is for blood pressure to increase as we age. Ongoing regular screenings provide early detection and the opportunity for early intervention, limiting the risk of developing hypertension in the future. Do your heart a favor and check your blood pressure.
Bradford Croft, DO
East Flagstaff Family Medicine