If all Americans managed their high blood pressure, there
would be 56,000 fewer strokes and heart attacks each year, according to a new
study in the New
England Journal of Medicine.
Researchers found better management of hypertension would
save 13,000 lives each year without adding more costs to health care.
As it is, 44 percent of Americans with high blood pressure
today are not controlling their condition, according to the researchers of the
study from the University of California and Columbia University.
“For most people, high blood pressure is asymptomatic,” said
Dr. Gary Renaldo, a cardiologist with Novant Health in Winston-Salem and Kernersville,
Many people may not even realize that they have high blood
pressure, which is why the American Heart Association refers to the condition
as “a silent killer.” The association recommends
that people, particularly as they age, have their blood pressure checked by a
health care professional.
In many patients, there are factors other than age
contributing to hypertension, including a diet that is too high in sodium, underlying
obesity and sleep apnea, according to Renaldo.
“It is another common condition I look for which is often
not recognized or treated,” he said of sleep apnea. “It could be the sole
reason for the hypertension.”
The study concluded that if more Americans tested their
blood pressure at home, sought medical evaluations for blood pressure and took
medications to treat the condition, more lives would be saved each year and
health care expenses would be lower.
In his experience, Renaldo said he finds that many patients
are resistant to the idea of taking medications to control high blood pressure.
“It takes convincing,” he said. “Many people resist because they think they’re
But the medications are effective and not expensive,
according to Renaldo. “Most patients can be treated with generic drugs,” he
Not all drugs are equally effective for managing high blood
pressure; some work better than others with differing patient populations.
“African Americans are very sodium sensitive,” Renaldo said.
“They respond well to diuretics, calcium channel blockers or both. Ace inhibitors
are effective for hypertension and have additional benefits in diabetics.”
The Centers for Disease Control and Prevention says 67 million Americans have
high blood pressure, or 1 in 3 people. In addition, hypertension cost the
United States $93.5 billion in health care services, medications and missed
days of work in 2010.
Last year, the U.S. National Heart, Lung and Blood Institute
guidelines for treating patients with hypertension. Under the new rules,
some blood pressure goals were less aggressive in some age groups. Threshold
levels for treatment were raised for people older than 60, for instance.
Normal blood pressure
in adults 18 years or older is a systolic, or top number, of 120 or less and a
diastolic, or bottom number, of 80 of less. Americans with stage 1 high blood
pressure have systolic readings between 140-159 or diastolic readings between
90-99. Those at elevated risk (stage 2)
have systolic readings of 160 or higher or diastolic readings of 100 or higher.
In the study, researchers looked specifically at lives saved
and treatment costs for adults age 35-74 based on the new guidelines.
Hypertension runs in families, Renaldo said. Patients should
check their blood pressure at their doctor’s office or at a clinic or pharmacy
to determine whether they have hypertension.
If a patient has high blood pressure, changes in diet,
weight loss and a screen for sleep apnea can help. Renaldo recommended patients
keep a diary of blood pressure checks done at home using an arm cuff to share during
their next doctor’s visit.
Find additional health and wellness tips at NovantHealth.org/RemarkableYou.