What is considered high blood pressure?
- Hypertension: systolic blood pressure is consistently elevated above 140 mm Hg, or diastolic blood pressure is above 90 mm Hg.
- Pre-hypertension: is untreated systolic blood pressure of 120 to 139 mm Hg or untreated diastolic blood pressure of 80 to 89 mm Hg
- Prevalence: 10 – 15% of white adults and 40% of black adults in the United States.
- The prevalence of this condition is nearly equal between men and women.
- Data from NHANES 1999–2006 estimate that 29.7% of adults ?20 years of age have pre-hypertension
Hypertension is the major risk factor for heart disease. Roughly every 34 seconds, one American has a heart-related event, and approximately every minute, an American will die of one. The total cost of cardiovascular-disease management is continuing to increase. According to the National Heart, Lung, and Blood Institute, the total direct and indirect cost of heart and vascular disease and stroke in the United States in 2009 was estimated to be $312.6 billion. This cost is significantly higher than the costs associated with cancer management, which were around $228 billion in 2008.
The estimated direct and indirect cost of high blood pressure in 2009 is $51.0 billion.
Sad News about Hypertension Management
Only about half of the people with high blood pressure have their condition under control.
A preventable disease
Almost one in three Americans have pre-hypertension—blood pressure numbers that are higher than normal, but not yet in the high blood pressure range. Pre-hypertension raises an individual’s risk of developing high blood pressure and can be prevented.
For instance, reducing the average sodium intake from 3,300 mg to 2,300 mg per day may reduce cases of high blood pressure by 11 million.
Most common causes and risk factors
Genetics, age, ethnicity, kidney disease, hormonal issues such as adrenal gland over- function, smoking, higher weight, stress, sleep apnea, high sodium and alcohol intake, thyroid problems and medication use are increased risk factors for hypertension.
Uncontrolled high blood pressure can result in stroke, heart attack, dementia and aortic dissection.
Treating high blood pressure
Hypertension can be managed by multiple medications but also to some degree with life style changes. Studies have shown that diet modifications and exercise can result in various levels of success. There is no question that lifestyle changes should be the primary treatment option for patients presenting with pre-hypertension or already diagnosed hypertension. It is well known that high blood pressure can also be treated more easily if managed early. According to the Centers of Disease Control and Prevention, only one-third of patients with hypertension have their blood pressure under control. In other words, the rest of the population (two-thirds) comprises possible candidates for experiencing cardiovascular events in the future.
Following dietary and lifestyle changes can make a difference
Sodium: The main source of sodium in Western diets is processed food. Excessive quantities of salt are contained in packaged food and in food eaten outside the home. As mentioned previously, reducing the average sodium intake from 3,300 mg to 2,300 mg per day may reduce cases of high blood pressure by 11 million. A DASH dietary pattern with low sodium reduced systolic blood pressure by 7.1 mm Hg in adults without hypertension and by 11.5 mm Hg in adults with hypertension. Reducing the numbers of patients with hypertension with a small tweaking of their food, is very impressive.
Alcohol: limiting alcohol intake to no more than 1 oz (30 mL) of ethanol, the equivalent of two drinks per day for most men and no more than 0.5 oz of ethanol (one drink) per day for women and lighter-weight persons. Moderate alcohol consumption can reduce systolic blood pressure by 2–4 mm/Hg .
Caffeine: may result in high blood pressure. However, this effect is usually temporary. Coffee intake should be less than two cups per day.
Potassium: Intake (i.e., below 40 mEq) is thought to be associated with high blood pressure. It has been suggested that an intake of up to 120 mEq (4.7 g) of potassium could be beneficial to patients with high blood pressure.
Fiber: High fiber intake could reduce systemic blood pressure especially in older (>40 years) rather than younger patients. The good news is that high fiber intake can also reduce blood cholesterol levels. That is one of the reasons why fiber intake of more than 25 g has been recommended for the maintenance of a healthy and functional body.
Fish oil: A median dose of 3.7 g per day provided a significant reduction in systemic blood pressure.
Folic acid: A daily intake of 5 mg of folic acid could be beneficial in reducing systolic blood pressure.
Coq10: May have the potential to reduce systolic blood pressure by up to 17 mm Hg and diastolic blood pressure by up to 10 mm Hg without any significant side effects. An average dosage of 217 mg/day of CoQ10 has been shown to reduce blood pressure.
An estimated 78 million U.S. Americans have hypertension, but unfortunately only half of this population has their blood pressure under control. High blood pressure is a risk for heart attack, stroke, kidney failure, dementia and many other conditions. Patients with mildly high blood pressure can control and manage their condition with lifestyle changes including dietary adjustments. Some of the commonly used prescription and over the counter medications could elevate blood pressure and result in difficulty controlling this disorder .
- CDC. Vital signs: prevalence, treatment, and control of hypertension—United States, 1999-2002 and 2005-2008. MMWR. 2011;60(4):103-8.
- Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012;125(1):e2–220.
- Palar K, Sturm R. Potential societal savings from reduced sodium consumption in the U.S. adult population. American Journal of Health Promotion. 2009;24(1):49–57.