High blood pressure, also known as hypertension, is one of the most common health conditions affecting more than half of US adults. It also represents a leading risk factor for heart disease and stroke.
The good news is that hypertension is often preventable and highly treatable through a combination of healthy lifestyle choices, routine monitoring, and medication when needed.
Saint Alphonsus Invasive/Non-interventional cardiologist Dr. Matthew Nelson answers some common questions about hypertension and how to keep your blood pressure under control.
What risk factors for hypertension can be changed, and which cannot?
The one risk factor none of us can really change is getting older. Most people increase blood pressure as they age.
That being said, there are other risk factors that someone can change to reduce blood pressure. For example, using NSAIDs like ibuprofen or Advil daily can increase blood pressure.
Finding an alternative such as Tylenol may lead to lower blood pressure. If you have sleep apnea, treating this can lower your blood pressure by 2-10 points.
How does hypertension affect your arteries and heart?
Over time, high blood pressure places significant stress on both the arteries and the heart. This ongoing strain can cause:
- Hardening of the arteries.
- Thickening of the heart muscle.
- Increased risk of heart attack and stroke.
Because the damage occurs gradually, many people may not realize the impact uncontrolled blood pressure is having on their cardiovascular system until serious complications develop.
What can untreated hypertension lead to?
Untreated high blood pressure can have serious consequences, including:
- Heart attack.
- Stroke.
- Kidney failure.
- Peripheral arterial disease.
One of the clearest examples of the dangers of uncontrolled high blood pressure is the story of President Franklin D. Roosevelt. During his lifetime, effective medications to treat hypertension simply did not exist. As president during some of the most stressful years in American history, including World War II, he lived with severely elevated blood pressure that could not be adequately managed.
At the time of his death, Roosevelt's blood pressure was reported to be around 300/190 mmHg, and he ultimately suffered a fatal hemorrhagic (bleeding) stroke.
Fortunately, outcomes like this are far less common today. With routine blood pressure screening, effective medications, and lifestyle interventions, hypertension can often be managed successfully. Left untreated, however, high blood pressure can still cause serious damage over time, increasing the risk of heart attack, stroke, kidney failure, and peripheral artery disease.
What lifestyle changes can help lower blood pressure?
Lifestyle changes can have a powerful impact on blood pressure control. Healthy habits that may help include:
- Losing weight, which can lower blood pressure with even modest weight loss.
- Eating more fruits and vegetables and reducing saturated fat intake.
- Using olive oil regularly as part of a heart-healthy diet.
- Exercising regularly, including both aerobic and strength-training activities.
- Reducing sodium intake, especially for individuals who consume high-salt diets.
- Cutting back on sugary foods and drinks.
- Limiting or eliminating alcohol use.
- Quitting smoking.
For many people, these changes can significantly reduce blood pressure and improve overall heart health.
What types of medicine are used to treat hypertension?
There are generally three classes of medications that we use to treat high blood pressure.
As I tell my patients, everything that has an effect has a side effect.
There are different classes of medications depending on the patient’s health needs including:
- Mild diuretics, which can cause people to urinate more and affect electrolytes.
- Calcium channel blockers, which can sometimes lead to swelling of the legs.
- ACE inhibitors or angiotensin receptor blockers, which can increase potassium in the body.
These medications are very powerful and can manage most cases of hypertension whether alone or in combination.
Are there disparities in hypertension care and outcomes?
While racial and socioeconomic disparities in hypertension care do exist, blood pressure screening is widely accessible and often available at no cost through pharmacies, grocery stores, fire stations, and healthcare providers.
The medications used to treat hypertension are also generally affordable and widely available in generic forms.
The Bottom Line
Hypertension is often called the "silent killer," because it can cause significant damage long before symptoms appear. Regular blood pressure checks, healthy lifestyle choices, and a clear treatment plan can dramatically reduce the risk of heart attack, stroke, and other serious complications.
If you haven't had your blood pressure checked recently, now is a great time to know your numbers and take charge of your heart health.
