High blood pressure is about numbers, including how old you are, how much you weigh, how much salt you ingest, how much you exercise and what other risk factors you have.
Here are some other numbers to consider:
▪ One in three. That’s how many American adults are affected by hypertension, the medical term for elevated or high blood pressure, according to the Centers for Disease Control and Prevention. That’s about 75 million people. Even kids can develop it, the CDC says.
▪ 360,000. That’s how many deaths in America in 2013 — about 1,000 a day — were related to hypertension, according to the CDC. Hypertension was reportedly cited as the underlying cause for the fatal stroke celebrity Debbie Reynolds had in late December.
▪ 140/90 and 150/90. Those are the newer recommended blood pressure readings — depending on your age and risk factors — for starting treatment.
▪ 54 percent. That’s how many people the CDC says have their blood pressure under control.
For a few years, 76-year-old Esther Lakin from El Dorado had her high blood pressure under control with medication, she said. She didn’t worry about it too much, she said, thinking that her age likely contributed to her having developed hypertension.
James Smith, an osteopath and vascular medicine specialist with Kansas Vascular Medicine, said age does indeed have something to do with it.
“As we age, our blood vessels get stiffer, and stiff blood vessels cause the blood pressure to rise,” he said.
Blood pressure is the measurement of how hard the blood has to push against the walls of your arteries to circulate around your body. The top number in the measurement is the systolic pressure, which gauges the force of the arteries when the heart contracts to push the blood into the artery system. The bottom number is the diastolic pressure. That’s the pressure during the short time of relaxation between heart beats. Healthy, young vessels tend to be elastic and smooth on the inside, letting the blood flow pretty easily.
‘At higher risk’
Uncontrolled and consistently high blood pressure can take a toll on the body. It can cause damage to organs, including the eyes, kidneys, brain and heart, leading to heart disease or a stroke.
“High blood pressure puts you at higher risk for stroke,” said Dr. Andre Saad, a cardiologist with Via Christi Clinic. “Most people should be scared to have a stroke, even myself, because that can be a major life change.”
Last year, Lakin’s blood pressure started getting out of control. It was fatigue and a lack of energy, however, that caused her to go to the doctor to get some answers. High blood pressure doesn’t really have symptoms, say medical experts, and that’s why it’s called a silent killer.
Lakin’s physician told her her blood pressure was getting too high, and she started keeping tabs on it with a home monitor.
“All of a sudden it was fluctuating. It was 190/80 or 168/70 or 179/93,” she said. “I could have had a stroke at any time, but what could I do to change it but to go to the doctor and find out what to do.” She ended up on five different medications that still seemed to have no effect.
In Lakin’s case, her physician referred her to Smith, to see if there was an underlying cause. There was. One of her kidneys had shut down and an artery leading to her still-functioning kidney was severely blocked. On Feb. 16, she underwent a stent procedure, performed by Smith, to open the artery. Within days, one of her readings was 115/56. Doctors have told her she may be able to reduce the number of medications she’s on to control the blood pressure.
For years, the blood pressure reading 120/80 was considered the baseline. Because of more current studies, the guidelines for when to start treatment have changed, according to Saad. The new guidelines are based more on age and the degree of risk factors such as diabetes or kidney disease, he said.
The guidelines, issued in 2014, are the recommendations of the Eighth Joint National Committee, a group of hypertension experts that included folks such as a senior scientist from the National Institute of Diabetes and Digestive and Kidney Diseases and a senior medical officer from the National Heart, Lung, and Blood Institute. They published a report in the Journal of the American Medical Association.
In general, the guidelines for when patients should be considered for treatment:
▪ 140/90 for those under age 60,
▪ 140/90 for anyone diagnosed with diabetes or kidney problems,
▪ 150/90 for those age 60 or older with no history of kidney or heart problems or diabetes.
“These are guidelines,” Saad said. “In real practice, it’s more of a patient to patient thing.”
Getting it under control
There are several ways individuals can prevent risks and control high blood pressure, said Saad and Smith.
Here is what they recommend:
▪ Exercise. “You don’t need to run a marathon,” said Saad. Your goal should be 50 minutes of exercise a day, five days a week, he said. The better benefits come from doing cardiovascular, or cardio, exercises because the faster heart rate and elevated pressure that happen during those exercises are also exercising your vessels to help them not stiffen, Smith explained. “In my experience, the time to really begin cardiovascular fitness is 40. If you are 50 or 60, you better get going.” For those over 40, an ideal amount of cardio exercise is 30 minutes five times a week, Smith said.
▪ Watch your weight. The higher your BMI, or body mass index, number, the higher your blood pressure is likely to be and the higher your risk. An online tool to calculate your BMI is at cdc.gov/healthyweight.
▪ Eat healthier and limit salt intake. Lakin, Smith’s patient, said she plans to continue eating in moderation and keeping her salt intake low, just as she did when her high blood was uncontrolled. Read labels to limit your sodium intake to less than 2,000 milligrams a day, said Saad. Eat in moderation. Consider a diet that also limits sugar and includes plenty of fruits and vegetables and lean sources of protein.
▪ Quit smoking. The nicotine can increase blood pressure. According to the American Heart Association, exposure to cigarette smoke can increase the risk for the plaque-buildup in arteries that can affect circulation.
▪ Limit your intake of caffeine and over-the-counter medications, such as ibuprofen, which can also affect your high blood pressure.