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The Cost of High Blood Pressure: 50,000 Deaths a Year

~ by Jo Jordan

In 2004, nearly fifty-five thousand American death certificates listed high blood pressure as the cause of mortality.1

The American Heart Organization reports that approximately seventy-three million adults – age twenty and older – have high blood pressure; that’s one third of all American adults. Unfortunately, nearly the same percentage of the population is unaware that they even have high blood pressure.2

While the cause of high blood pressure is not entirely understood, combined with obesity, hypertension – by which it is commonly known – puts sufferers at risk for a variety of other diseases including heart disease, kidney cancer, and stroke.3


What Is Blood Pressure?

Your arteries function much like a series of pipes, carrying blood from your heart to the rest of your body. When blood travels through the arteries at a higher than normal pressure, hypertension is the resulting condition.

A blood pressure reading is a method of measuring the force of your blood on artery walls. This is measured in two ways:

Systolic blood pressure is the first number. It is the reading taken right after your heart beats. This is the peak of blood pressure when your heart is squeezing blood out.

Diastolic blood pressure is the second number. It is the reading taken between heartbeats. This is the blood pressure when your heart is filling with blood, or resting between beats.

In a healthy adult, blood pressure measures less than 120/80 mmHg (units of atmosphere pressure). In this case, the systolic pressure is 120 and the diastolic pressure is 80.

It is vital to achieve a healthy reading for both your systolic and diastolic blood pressure measurement. This varies between individuals, so it is important to discuss your blood pressure goals with your health care provider. In people with diabetes, for example, blood pressure should read less than 130/80. For those with kidney disease, however, an ideal blood pressure reading is lower than 130/80.

High blood pressure is generally defined as a reading greater than 140/90 mmHg. Dependent on a variety of factors, blood pressure changes frequently throughout the day, so in order to get an accurate reading, it may be necessary to measure it several times in a calm setting.


Two Types of Hypertension

In ninety to ninety-five percent of adult high blood pressure cases, the cause is unknown. Developing slowly over a number of years, this type of high blood pressure is called primary or essential hypertension.

Only five to ten percent of high blood pressure cases are directly attributable to a known cause such as a disease or drug. Appearing suddenly and causing higher blood pressure than that caused by primary hypertension, this type of high blood pressure is called secondary hypertension. The conditions and medications that lead to secondary hypertension include,

  • Certain types of congenital heart defects


  • Certain medications such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers, and some prescription drugs


  • Illegal drugs such as amphetamines and cocaine


  • Kidney abnormalities


  • Tumors of the adrenal gland


Risk Factors for High Blood Pressure

While the causes of hypertension are not fully understood, there are certain known risk factors. These include,

  • Age – people over fifty years of age are at greater risk


  • Being overweight and/or obese


  • Certain chronic conditions including high cholesterol, diabetes, kidney disease, and sleep apnea


  • Cigarette smoking


  • Family history of hypertension


  • Inadequate potassium in the diet


  • Inadequate vitamin D in the diet


  • Lack of physical activity


  • Pregnancy can sometimes contribute to high blood pressure


  • Race – blacks have a higher incidence of hypertension, and a greater likelihood of developing kidney damage from the condition


  • Stress


  • Too much alcohol (more than two standard drinks per day) may cause your body to release hormones that increase your blood flow and heart rate


  • Too much salt (sodium) in the diet


Hypertension Complications

Controlling high blood pressure can help to prevent serious complications linked to the condition such as blood vessel damage of the legs – which may lead to amputation – heart attack, heart failure, kidney failure, and stroke. If you suffer from kidney disease, maintaining healthy blood pressure levels can slow the decrease in kidney function.

Specific complications include,3

  • Aneurysm – a weakening and subsequent bulge in a blood vessel can be life-threatening


  • Artery damage – can lead to hardening and thickening of the arteries, and eventually heart attack, stroke, and other problems


  • Brain blood vessel blockage or rupture – high blood pressure in the arteries leading to your brain can slow blood flow to the brain or cause a blood vessel in your brain to burst, leading to a stroke


  • Eye blood vessel thickening and narrowing – can result in vision loss


  • Heart failure – the thickened heart (caused by the additional pressure in your vessels) may struggle to pump sufficient blood to the body, leading to failure


  • Kidney blood vessel weakening and narrowing – can prevent the organ from functioning normally


  • Memory or comprehension difficulties – is a problem more common in those with high blood pressure than it is for others


  • Metabolic syndrome – a cluster of disorders of the body's metabolism including increased waist circumference, high triglycerides, low high-density lipoprotein (HDL or good cholesterol), high blood pressure, and high insulin levels that increase the risk of developing diabetes, heart disease, or stroke


High blood pressure is also a risk factor for kidney disease; some research indicates a link between high blood pressure and kidney cancer.5

Diagnosing Hypertension

High blood pressure is a silent disease; there are no specific symptoms. It is important, therefore, beginning in your early twenties, and especially on into middle age, to have your blood pressure checked every year or two, particularly if you are at risk. In most cases, high blood pressure develops over a long period of time. Eventually, nearly everyone is affected in some way by the condition.

If there are symptoms, they typically don't appear until the advanced, or even life-threatening, stage of hypertension. Some people, however, with early-stage high blood pressure may experience dizziness, headaches, or a higher than average number of nosebleeds.

Blood pressure is measured using a blood pressure cuff secured around one arm. As the device is inflated, your health care provider can listen to the flow of blood.

Your blood pressure fluctuates a great deal throughout the day, so an abnormal or high reading does not necessarily mean you have hypertension. If your first reading is higher than it ought to be, it will be necessary to have it measured again to confirm whether or not you have high blood pressure. However, if your blood pressure is high on more than two readings, it is likely that you suffer from hypertension.


Control and Prevention of High Blood Pressure

While there is no cure for high blood pressure, lifestyle changes – predominantly diet and exercise – can help treat, control, and reduce the chance of developing the condition and/or the problems associated with it.

  • Eat healthy foods such as fruits, low-fat dairy foods, vegetables, whole grains, and vegetables; reduce saturated fat and total fat intake


  • Get thirty to sixty minutes of moderate exercise, four to seven days a week


  • Limit alcohol consumption


  • Maintain healthy body weight


  • Manage stress; relax and engage in enjoyable activities


  • Monitor blood pressure at home


  • Quit smoking


  • Reduce salt intake


Although it is preferable to obtain most of your nourishment through the foods you eat, supplements can be a helpful alternative if you are not getting adequate amounts of the following:

  • Alpha-linolenic acid (an essential fatty acid found in canola oil, flaxseed, and walnuts)


  • Blond psyllium (also known as plantago or flea seed)


  • Calcium (found in dairy products, greens, and salmon)


  • Cocoa


  • Cod liver oil


  • Coenzyme Q10 (found predominantly in fish and meat)


  • Garlic


  • Magnesium (found in green vegetables, nuts, shellfish, and whole grains)


  • Omega 3 fatty acids (found in oily fish such as anchovies, herring, mackerel, salmon, and sardines; fresh or frozen tuna; dark green vegetables; canola, sunflower, and flaxseed oils; and walnuts)


  • Potassium (found in apricots, bananas, bran cereal, cantaloupe, navy beans, potatoes, prunes, raisins, spinach, squash, and tomatoes)


Be sure to discuss the possible side effects of supplements – especially interactions with medications – with your health care provider.

For more information on healthy eating, dietary suggestions, weight loss, and fitness, check out our many articles:

Medication for Hypertension: When Is It Necessary?

Unfortunately, lifestyle changes sometimes fail to sufficiently decrease blood pressure levels. In such cases, as in those where blood pressure is extremely high, it will be necessary for the sufferer to take prescription medication, likely for the rest of her life.

There are many types of blood pressure medication, also known as antihypertensives:6

  • Alpha blockers – reduce nerve impulses to blood vessels, minimizing the effects of natural chemicals that constrict blood vessels


  • Alpha-beta blockers – reduce nerve impulses to blood vessels and slow the heartbeat, reducing the amount of blood to be pumped through the vessels


  • Aliskiren (Tekturna) – a renin inhibitor, aliskiren slows renin production; renin initiates a series of reactions that increase blood pressure


  • Angiotensin-converting enzyme (ACE) inhibitors – prevent blood vessels from constricting by blocking the making of angiotensin II, a natural chemical that narrows blood vessels


  • Angiotensin II receptor blockers – act like ACE inhibitors, but block angiotensin from acting (rather than blocking its formation) on blood vessels


  • Beta blockers – counter the effects of adrenaline, reduce the heart’s workload, and open blood vessels to slow heart beat


  • Calcium channel blockers – relax the muscles of blood vessels by blocking calcium


  • Central-acting agents – prevent brain signals to the nervous system to increase heart rate and constrict blood vessels


  • Thiazide diuretics – sometimes referred to as water pills, these reduce blood volume by assisting with the elimination of sodium and fluid


  • Vasodilators – work on the muscles in the artery walls, preventing tightening, and keeping the arteries from narrowing


The Potential Side Effects of Antihypertensives

Everyone is unique in how they respond to medication, and each drug has the potential for a range of side effects. These can include,

  • A dry mouth
  • Bloating
  • Constipation
  • Coughing
  • Depression
  • Dizziness when standing up after lying down or sitting
  • Drowsiness
  • Erectile dysfunction
  • Lowered levels of potassium
  • Headaches
  • Sleeping problems

Discuss any changes you experience with your health care provider. If one type of medication doesn't work well, or causes unpleasant side effects, there are many other options. Do not stop taking high blood pressure medication, or alter your treatment, without consulting your physician.


High Blood Pressure: Long-term Prognosis

While there is no cure for hypertension, an optimistic prognosis is dependent on a variety of factors, some of which can be controlled. When high blood pressure is detected early and treated adequately, the prognosis is relatively good. Severe or longstanding cases can be more difficult to treat, as are those complicated by other conditions such as diabetes.

Early detection and an awareness of one’s overall health are vital to ensuring that this treatable condition does not become life threatening.

Since hypertension does not often present with symptoms, it is important to have regular check-ups to monitor blood pressure as well as to implement healthy lifestyle habits. If you already have high blood pressure, lifestyle changes and suitable medications can control blood pressure and greatly improve your long-term prognosis.


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Notes:
1. American Heart Association, “High Blood Pressure Statistics,” http://www.americanheart.org/presenter.jhtml?identifier=212 (accessed November 22, 2008).
2. Ibid.
3. New York-Presbyterian Hospital, “High Blood Pressure (Hypertension),” http://newyorkpresbyterianhospital.com/health/men_hbp.html (accessed November 22, 2008).
4. MayoClinic.com, “High blood pressure (hypertension), Complications,” http://www.mayoclinic.com/health/high-blood-pressure/DS00100 (accessed November 22, 2008).
5. Cancer Research UK, “Risks and causes of kidney cancer,” http://www.cancerhelp.org.uk/help/default.asp?page=4032 (accessed November 22, 2008).
6. MayoClinic.com, “High blood pressure (hypertension), Treatments and drugs,” http://www.mayoclinic.com/health/high-bloodpressure/DS00100 (accessed November 22, 2008).


 
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