> > > >"High blood pressure 'is a smoldering public health crisis,' said Dr. > Rishi K. Wadhera, an associate professor of medicine at Harvard Medical > School." > > >"High blood pressure can raise the risk of heart attack, stroke > <https://www.cdc.gov/bloodpressure/facts.htm#:~:text=Having%20hypertension%20puts%20you%20at,death%20in%20the%20United%20States.&text=In%202021%2C%20hypertension%20was%20a,deaths%20in%20the%20United%20States.> > , pregnancy complications > <https://www.cdc.gov/bloodpressure/pregnancy.htm#:~:text=The%20mother's%20high%20blood%20pressure,to%20deliver%20the%20baby%20early.> > and other health problems, but the symptoms are 'often silent,' Dr. > Wadhera said." > > >"Blood pressure is the force that blood exerts against artery walls > <https://www.heart.org/en/news/2022/05/23/monitoring-blood-pressure-at-home-can-be-tricky-heres-how-to-do-it-right> > in the heart, said Dr. Jim Liu, a cardiologist at the Ohio State > University Wexner Medical Center." > > >"Multiple risk factors have been linked to high blood pressure, including > smoking > <https://www.nytimes.com/2015/02/12/health/smokings-health-toll-worse-than-previously-thought-study-says.html> > , heavy drinking > <https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.123.21224>, > obesity > <https://www.cdc.gov/bloodpressure/prevent.htm#:~:text=Keep%20Yourself%20at%20a%20Healthy,CDC's%20Assessing%20Your%20Weight%20website.> > and chronic stress > <https://www.nytimes.com/article/how-to-deal-with-stress.html>. A lack of > exercise and diets high in sodium and processed foods > <https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/shaking-the-salt-habit-to-lower-high-blood-pressure> > have also been associated with an increased risk of hypertension." > > >“'Blood pressure is the most modifiable risk factor for heart disease > and stroke,' Dr. Gulati [Martha, the director of preventive cardiology at > the Smidt Heart Institute at Cedars-Sinai in Los Angeles] said. 'With > lifestyle changes and medications, our patients can take control of it — > and their heart health.'” > ---------------------- > By: Liz Szabo > Published in: *The New York Times* > Date: February 29, 2024 > And how to get it under control. > > High blood pressure “is a smoldering public health crisis,” said Dr. Rishi > K. Wadhera, an associate professor of medicine at Harvard Medical School > and an author of new research showing that blood pressure screenings > <https://jamanetwork.com/journals/jama-health-forum/fullarticle/2814606> have > not returned to what they were before the coronavirus pandemic. > > High blood pressure can raise the risk of heart attack, stroke > <https://www.cdc.gov/bloodpressure/facts.htm#:~:text=Having%20hypertension%20puts%20you%20at,death%20in%20the%20United%20States.&text=In%202021%2C%20hypertension%20was%20a,deaths%20in%20the%20United%20States.> > , pregnancy complications > <https://www.cdc.gov/bloodpressure/pregnancy.htm#:~:text=The%20mother's%20high%20blood%20pressure,to%20deliver%20the%20baby%20early.> > and other health problems, but the symptoms are “often silent,” Dr. > Wadhera said. > > “I worry it flies under the radar for many patients,” he added. > > Here’s what to know about the issue, and how to get your blood pressure > under control. > What is blood pressure? And what’s a normal level? > Blood pressure is the force that blood exerts against artery walls > <https://www.heart.org/en/news/2022/05/23/monitoring-blood-pressure-at-home-can-be-tricky-heres-how-to-do-it-right> > in the heart, said Dr. Jim Liu, a cardiologist at the Ohio State > University Wexner Medical Center. You’ll always hear your blood pressure > given as two numbers: The top number, known as systolic pressure, measures > that force when the heart contracts. The bottom number, known as diastolic > pressure, gauges the force when the heart muscle relaxes. It’s measured > in units known as millimeters of mercury > <https://www.ncbi.nlm.nih.gov/books/NBK279251/>, or mm Hg. > > You can have your blood pressure checked during a medical appointment or > at a pharmacy, or you can check it yourself with a home monitor. The > American Heart Association and the American College of Cardiology define > normal blood pressure > <https://newsroom.heart.org/news/high-blood-pressure-redefined-for-first-time-in-14-years-130-is-the-new-high> > as below 120/80 mm Hg. The C.D.C. defines high blood pressure as 130/80 > mm Hg or higher. > > Very high blood pressure can cause symptoms > <https://www.who.int/news-room/fact-sheets/detail/hypertension> including > severe headaches, chest pain and dizziness. For many people, however, blood > pressure increases too gradually for them to notice these issues, Dr. Liu > said. > > Why is high blood pressure harmful? >
> High blood pressure forces the heart to work harder to pump blood. Over > time, the overwhelmed heart can slowly start to falter and struggle to pump > blood out to the rest of the body, a condition called heart failure. > > The force and friction of high blood pressure can also injure the > delicate lining of the arteries > <https://www.nyp.org/healthlibrary/multimedia/how-high-blood-pressure-damages-arteries#:~:text=High%20blood%20pressure%20means%20that,lead%20to%20many%20health%20problems.> > , Dr. Liu said. Tears in the artery wall allow LDL cholesterol > <https://www.nytimes.com/2024/01/31/well/live/cholesterol-tests-levels-heart-disease.html> > — also known as the “bad” cholesterol — to latch on and form clumps, or > plaques, in these gaps. This can block blood flow and, in some patients, > cause a heart attack. > > Blockages in arteries that carry blood to the brain can lead to a stroke. > Long-term damage to blood vessels in the brain can also lead to a > condition called vascular dementia > <https://www.bloodpressureuk.org/your-blood-pressure/understanding-your-blood-pressure/why-is-high-blood-pressure-a-problem/vascular-dementia-and-high-blood-pressure/#:~:text=Over%2520time%252C%2520uncontrolled%2520high%2520blood,refers%2520to%2520the%2520blood%2520vessels.> > , Dr. Liu said. > > What leads to high blood pressure? > All arteries stiffen over time, leading blood pressure to climb steadily > as people age. By age 75, an estimated > <https://pubmed.ncbi.nlm.nih.gov/31992061/> 80 percent of men and 86 > percent of women in the United States have high blood pressure > <https://www.heart.org/en/news/2020/05/18/is-high-blood-pressure-inevitable-heres-how-to-keep-it-in-check> > . > > Multiple risk factors have been linked to high blood pressure, including > smoking > <https://www.nytimes.com/2015/02/12/health/smokings-health-toll-worse-than-previously-thought-study-says.html> > , heavy drinking > <https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.123.21224>, > obesity > <https://www.cdc.gov/bloodpressure/prevent.htm#:~:text=Keep%20Yourself%20at%20a%20Healthy,CDC's%20Assessing%20Your%20Weight%20website.> > and chronic stress > <https://www.nytimes.com/article/how-to-deal-with-stress.html>. A lack of > exercise and diets high in sodium and processed foods > <https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/shaking-the-salt-habit-to-lower-high-blood-pressure> > have also been associated with an increased risk of hypertension. > > How can you reduce your blood pressure? > For some people, lifestyle changes can be as powerful as medication, said > Dr. Martha Gulati, the director of preventive cardiology at the Smidt Heart > Institute at Cedars-Sinai in Los Angeles. She recommends at least 30 > minutes > <https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974#:~:text=It's%20important%20to%20keep%20exercising,high%20blood%20pressure%20(hypertension).> > of moderate exercise a day and sleeping seven to nine hours a night > <https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/diagnosis-treatment/drc-20373417#treatment> > , both of which are associated with lower blood pressure. Maintaining or > achieving a healthy body weight can also reduce blood pressure, Dr. Gulati > said. > > Avoiding products that contain nicotine is important. Using nicotine drives > up blood pressure > <https://www.heart.org/en/healthy-living/healthy-lifestyle/quit-smoking-tobacco/how-smoking-and-nicotine-damage-your-body> > , narrows blood vessels and may contribute to the hardening of arteries, > according to the American Heart Association. > > Some research suggests > <https://bcmj.org/sites/default/files/BCMJ_54_Vol8_lifestyle_mods.pdf> that > following a low-sodium diet could reduce blood pressure by two to eight mm > Hg for some patients, and that adopting the DASH diet — which emphasizes > fruits, vegetables and low-fat dairy products — could reduce blood pressure > by eight to 14 points. Abstaining from alcohol or limiting consumption to > no more than one glass per day for women and two glasses for men could > reduce blood pressure by two to four points. > > People who can’t lower their blood pressure to normal levels through > lifestyle changes will need medication, Dr. Gulati said. Water pills, or > diuretics, help remove sodium and water from the body, bringing down blood > pressure. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II > receptor blockers (ARBs) both relax blood vessels, though they work in > different ways. Calcium channel blockers help relax the muscle cells of > blood vessels, and some slow your heart rate. People who can’t lower their > blood pressure with these drugs may need additional medications. Doctors > take a patient’s age, health and risk factors into consideration before > deciding what medication to prescribe. > > “Blood pressure is the most modifiable risk factor for heart disease and > stroke,” Dr. Gulati said. “With lifestyle changes and medications, our > patients can take control of it — and their heart health.” >
