Haims: The devastating effects of high blood pressure
High blood pressure is often referred to as the “silent killer” for good reason. Too often, people have no idea they are at risk.
Most people over high school age are aware that high blood pressure is not a good thing, but many may not be aware of the specific health concerns that may develop, and the possible devastating consequences if left unaddressed.
Elevated blood pressure may not only lead to heart disease, kidney diseases, neuropathy and stroke, but it has been linked to two of the most common causes of dementia, vascular cognitive impairment and Alzheimer’s disease. A study by Johns Hopkins researchers showed that midlife hypertension raises the odds of cognitive issues as people age. Fortunately, when addressed early, risks may drop considerably.
Between August 2021 and August 2023, data from the Centers for Disease Control in the United States shows “the prevalence of adult hypertension was 47.7%.” While it should be a little disturbing that just about half of us are at an elevated risk of life-threatening complications, what is disturbing is that the American Heart Association educates us that “about 14% of children and teens in the U.S. either have high blood pressure or are headed toward it.” Are we really going to continue to self-inflict this upon ourselves?
Blood pressure is represented as systolic over diastolic. Systolic is the pressure in our arteries when our heart beats and pumps blood. Diastolic is the pressure of our blood against our artery walls while the heart rests between beats. While both numbers are used to express our risk of heart disease, the systolic pressure is often considered a stronger predictor of life-threatening risks, especially in people over 50.
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Blood pressure is categorized into levels of risk. Generally, for people under the age of 65, “normal” blood pressure should be under 120/80 mmHg, while “elevated” or “pre-hypertension” is considered between 120-129/80 mmHg, and “high” or “stage 1 hypertension” is considered 130-139/80-89 mmHg. Although the CDC considers systolic blood pressure between 120–139 as being “elevated” or “at risk” of hypertension, there is plenty of research indicating that once a reading above 120/80 occurs for those under 65, caution should be taken.
For those over the age of 65, Harvard Health and the National Institute on Aging recommend that 130/80 should be a target blood pressure reading. The recommendation of a systolic reading from 120-130 is based on the fact that as people age, the arteries tend to become stiffer and less flexible, which can lead to the need for higher blood pressure to push blood from the heart to the brain.
It is important to understand that for those over 65, blood pressure is not a one-size-fits-all thing — one’s medical history and medical provider recommendations need to be considered.
Last year, a research study posted from the National Institutes of Health stated that for each 20 mmHg increase of systolic blood pressure, or 10 mmHg increase of diastolic blood pressure, the risk for fatal stroke or cardiovascular disease doubles.
Regardless of where you choose to find your credible data, it must be clear that your risk factor for life-altering events will most likely occur should you choose not to pay attention or take action when your blood pressure remains at an elevated level.
One of the best ways to be proactive in addressing your blood pressure is to establish and maintain an open dialogue with your primary care provider and cardiologist. Between 2015 and 2022, researchers at the Johns Hopkins Center for Health Equity published a study called the RICH LIFE Project. One of the notable results of the study included the fact that when a team approach was established among care managers, primary care clinicians, and remote specialists, the study found that such collaborations led to significant improvements in blood pressure outcomes.
In a February post, Doctor Luke Laffin, co-director for the Center for Blood Pressure Disorders at the Cleveland Clinic Main Campus, mentioned, “There are two avenues to lowering blood pressure: lifestyle changes and medication. Blood pressure management is often 70% lifestyle and 30% medication. If you take blood pressure medication but don’t make lifestyle changes, your medications likely won’t work as effectively.”
Other research from world-leading institutions like the CDC, Mayo Clinic, American Heart Association, and Harvard Health are just a few of many that have also shown that lifestyle changes can lower the risk. A pill is not always the answer. When lifestyle choice alone does not manage blood pressure as needed, there are a number of medications that have proven to assist in lowering blood pressure. As well, there are some groundbreaking medications being developed.
Findings from a clinical trial led by a Cleveland Clinic cardiologist showed that lorundrostat, a new type of blood pressure medication, significantly decreased blood pressure in patients with uncontrolled hypertension. Aprocitentan is also a new medication that is being used in conjunction with other medicines to treat high blood pressure.
If the following information is not already known to you, you are not paying attention to your health. Here are some of the recommendations from the Mayo Clinic:
- Get more exercise: walking, jogging, cycling, swimming, walking while playing golf, and dancing can help strengthen the heart and improve circulation.
- Achieve a healthy weight: The National Center for Biological Information states “that obesity accounts for 65–78% of cases of primary hypertension,” and the Mayo Clinic states, “If you’re overweight or have obesity, losing even a small amount of weight can help lower blood pressure.”
- Eat less salt and increase potassium (For those without kidney concerns, potassium has shown to assist the kidneys in purging excess sodium). The American Heart Association recommends no more than 1,500 milligrams of salt per day. High salt foods include deli meats, frozen foods, pizza, soda, processed snacks and condiments.
Incorporating a heart-healthy diet may be by far the best advice for living a long and healthy life. Although the Mediterranean diet may be considered one of the most well-known, there are others to consider, like vegetarian and vegan diets, or the DASH diet, which was specifically developed to address high blood pressure and therefore has more focus on less sodium, alcohol and saturated fats.
Health changes are not often successful when one tries to make quick and radical lifestyle changes. I encourage everyone to make gradual changes and collaborate with your medical providers.
Judson Haims is the owner of Visiting Angels Home Care in Eagle County. He is an advocate for our elderly and is available to answer questions. Connect with him at jhaims@visitingangels.com.
