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According to the Centers for Disease Control and Prevention, nearly half of American adults have high blood pressure. Hypertension (another name for high blood pressure) is a major contributing factor to heart disease and stroke, which are the leading causes of death worldwide. In the United States, one in five adults with hypertension is unaware that they have high blood pressure.
How common is high blood pressure? Why is it important to get diagnosed? How is it treated? Besides medications, what lifestyle factors can help lower high blood pressure? For someone diagnosed, what is the most important thing to change first?
To find out more, we spoke to CNN wellness expert Dr. Liana Wen, an emergency physician and adjunct associate professor at George Washington University. She previously served as the health commissioner for the city of Baltimore.
CNN: Let's start with some facts. What is high blood pressure? How does high blood pressure cause health problems?
Dr. Liana Wen: Blood pressure is measured in millimeters of mercury or mmHg. He has two measurements for this. Systole (top number) measures the pressure in the arteries as the heart beats, and diastole (bottom number) measures the pressure in the arteries between heartbeats. Hypertension is generally defined as blood pressure above 130/80 mmHg. This is called stage 1 hypertension. Stage 2 is when blood pressure is consistently above 140/90 mmHg. Hypertension crisis is when 180/120mmHg. Treatment given by your health care provider depends on your blood pressure and accompanying symptoms, if any.
High blood pressure can damage multiple organs in the body. This condition can damage arteries and lead to heart disease. High blood pressure can cause arteries that supply blood to the brain to block or burst, leading to a stroke. It can also cause chronic kidney disease. People with chronic hypertension are at increased risk for other diseases, including being more likely to develop dementia. And high blood pressure can be fatal if left untreated. High blood pressure is the leading cause or contributing factor to more than 691,000 deaths in the United States in 2021, according to the CDC.
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You can test your blood pressure at your doctor's office, local pharmacy, or even at home using your own blood pressure monitor.
CNN: Can people tell they have high blood pressure based on whether they have symptoms?
Wen: Some people experience symptoms such as chest pain, headaches, and blurred vision. However, these symptoms are late signs of high blood pressure because they are signs of organ damage. Most people with hypertension have no symptoms. This is why blood pressure testing is so important.
CNN: How common is high blood pressure? Are some groups more at risk than others?
Wen: Hypertension is one of the most common diseases, affecting an estimated 48% of U.S. adults. In the United States, more men than women have high blood pressure. The condition is also more common among non-Hispanic black adults than among non-Hispanic whites, Hispanics, and Asians. The reasons for these differences are complex and include a combination of biological and social factors. Also, people with a family history of high blood pressure are more likely to have high blood pressure themselves, and older people are more likely to have high blood pressure.
According to the World Health Organization, an estimated 1.28 billion adults aged 30 to 79 worldwide have high blood pressure. Nearly half are unaware they have the disease, and only 42% are diagnosed and treated.
CNN: How is high blood pressure treated?
Wen: There are two general categories of treatments for high blood pressure: medications and lifestyle changes.
There are many types of drugs approved to treat high blood pressure. They include diuretics, which help the body remove excess sodium and water; beta-blockers, which slow the heart rate and reduce the amount of work the heart has to do; calcium channel blockers and angiotensin-converting enzyme inhibitors, which relax and widen the blood. Contains drugs (ACE inhibitors). ship.
There are tablets that combine different classes of drugs. Some people start on one drug and then switch to another. Some people need more than one drug.
In addition to taking medications, patients diagnosed with high blood pressure are encouraged to change aspects of their lifestyle that raise blood pressure. These are similar lifestyle changes that can also be used as preventive measures. This means that it can prevent high blood pressure in people who have not yet been diagnosed with it.
CNN: What lifestyle changes can people make to better control their blood pressure?
Wen: I encourage people to take inventory of five important daily habits.
First, what is your level of physical activity? The CDC recommends at least 150 minutes of moderate-intensity exercise per week. Research shows that even half the recommended amount can have significant health benefits. People with desk jobs may also need additional exercise to compensate for long periods of sitting, so consider how often you get up to move during the day. must be evaluated.
Second, what is your current diet? Is it already very healthy, rich in whole foods like fruits, vegetables, and whole grains, or is it high in saturated fat and ultra-processed foods? Is it included?
Third, how much do you smoke, drink alcohol, and use other substances? Smoking, drinking excessively, and using substances such as marijuana and cocaine can significantly increase your risk of heart disease. It can also make your high blood pressure harder to control and make the negative effects of high blood pressure worse.
Fourth, what are your stress levels? Research has linked increased stress levels to increased blood pressure and cardiovascular diseases such as heart attacks and strokes.
Fifth, is your weight healthy? Obesity is a risk factor for high blood pressure. People who fall into the overweight category are also more likely to have high blood pressure. Losing weight through lifestyle changes or medication can also improve blood pressure control.
CNN: How important is each intervention? Can you rank them in order of what people should do first?
Wen: It depends on the individual. We recommend taking a five-area inventory and considering which areas need the most improvement and which areas are easiest to change.
For example, people who don't exercise at all may benefit from starting some physical activity. People who are quite physically active but smoke should consider quitting smoking. Additionally, if you're a non-smoker but regularly eat fast food, you should start by reevaluating your eating habits.
People should also be honest about what changes they can make and sustain. You don't have to do everything perfectly to make a difference in your health. Another good strategy is to start with low-hanging fruit, changes that you can implement right away and don't require a major lifestyle change. Many people cannot easily reduce stress in their lives, but you may find it easier to start eating more fruits and vegetables.
CNN: For patients newly diagnosed with high blood pressure, what is the most important thing to change first?
Wen: This depends on the individual. I encourage everyone to ask their health care provider and work with them to identify important changes that need to be made immediately.
People who have been diagnosed with slightly high blood pressure may be able to start by simply making lifestyle changes. On the other hand, for people with very high blood pressure, it is important to take the medication immediately. That is the most important intervention they should make.
In general, I advise people not to delay taking medications if necessary. Drugs that lower high blood pressure have been around for decades. They are safe and effective, and many options exist so that you can switch to another if you experience side effects. At the same time, you can also work on improving your lifestyle habits. With improved lifestyle changes, some patients eventually no longer need to take the medication. However, don't put off taking your medicine.
Remember, too, that controlling high blood pressure must be approached as a long-term health commitment. Although the damage high blood pressure does to your body accumulates over time, there are many steps you can take to control your blood pressure and stay healthy.
