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High Blood Pressure

High blood pressure (HBP) is defined as systolic pressure of 140 mm Hg or higher, or diastolic pressure of 90 mm Hg or higher, or taking antihypertensive medicine. "Prehypertension" is systolic pressure of 120-139 mm Hg, or diastolic pressure of 80-89 mm Hg, or both. Systolic pressure measures the beating heart and diastolic measures the heart resting between beats. In a healthy person, the arteries are muscular and elastic. They stretch when your heart pumps blood through them. How much they stretch depends on how much force the blood exerts.

Prevalence

  • 1 in 5 Americans (and 1 in 4 adults) has High Blood Pressure or HBP.
  • About 22 percent of American adults or about 45 million people have "prehypertension."
  • Of those with HBP, 30 percent don’t know they have it; 34 percent are on medication and have it controlled; 25 percent are on medication but don’t have their HBP under control; and 11 percent aren’t on medication.
  • A higher percentage of men than women have HBP until age 55. From ages 55-74 the percentage of women is slightly higher; after that a much higher percentage of women have HBP than men do.
  • HBP is 2-3 times more common in women taking oral contraceptives, especially in obese and older women, than in women not taking them.
  • About half of people who have a first heart attack and two-thirds who have a first stroke have blood pressures higher than 160/95 mm Hg.
  • People with systolic blood pressure of 160 mm Hg or higher and /or diastolic blood pressure of 95 mm Hg or higher have a relative risk for stroke about 4 times greater than for those with normal blood pressure.
  • The prevalence of hypertension in blacks in the United States is among the highest in the world. Compared with whites, blacks develop HBP earlier in life and their average blood pressures are much higher. As a result, compared with whites, blacks have a 1.3 times greater rate of nonfatal stroke, a 1.8 times greater rate of fatal stroke, a 1.5 times greater rate of heart disease death and a 4.2 times greater rate of end-stage kidney disease.
  • Within the African-American community, rates of hypertension vary substantially.
    • Those with the highest rates are more likely to be middle-aged or older less educated, overweight or obese, physically inactive, and to have diabetes.
    • Those with the lowest rates are more likely to be younger, but also overweight or obese.
    • Those with uncontrolled HBP who are not on antihypertensive medication tend to be male, younger and have infrequent contact with a physician.
  • Compared with white women, black women have an 85 percent higher rate of ambulatory medical care visits for HBP.
  • Hypertension precedes the development of congestive heart failure in 91 percent of cases. HBP is associated with 2-3 times higher risk for developing congestive heart failure.
  • 73 percent of Japanese-American men ages 71-93 have HBP.

Mortality

Total mentioned mortality – HBP was listed as a primary or contributing cause of death in about 251,000 of over 2,400,000 U.S. deaths in 2000.

  • From 1991 to 2001 the age-adjusted death rate from HBP increased 36.4 percent, but the actual number of deaths rose 53.0 percent.
  • The 2001 overall death rate from HBP was 16.5. Death rates were 13.7 for white males, 47.8 for black males, 13.4 for white females and 38.9 for black females.
  • As many as 30 percent of all deaths in hypertensive black men and 20 percent of all deaths in hypertensive black women may be due to HBP.

Cost

  • In 2004 the estimated direct and indirect cost of high blood pressure is $55.5 billion.
What Can You Do?

High blood pressure is a lifelong disease. It can be controlled but not cured. Once you begin to manage it and start a treatment program, maintaining a lower blood pressure is easier. By controlling your high blood pressure, you’ll lower your risk of diseases like stroke, heart attack, heart failure and kidney disease. You can do it!

If after having your pressure checked, it is found to be high, relax there are many things you and your doctor can do.

  1. You may be advised to use a lower-fat diet, a low-salt diet, and changes in your living habits such as losing weight and getting more exercise.
  2. If you are still smoking, you will be advised to quit. This time take it seriously.
  3. Your doctor may recommend that you reduce your use of alcohol.
  4. There are many medicines that can help reduce and control high blood pressure. Your doctor will decide whether you need medicine in addition to dietary and lifestyle changes.
  5. Read any patient education sheets you may be given. Knowledge is your friend.
  6. Be glad it was caught. You still have time to take control.
Success Stories - High Blood Pressure

William, age 68
I had always heard you were supposed to have your blood pressure checked from time to time, but I was a very healthy person, never sick so I didn’t even have a regular doctor. One day at work, the company was offering a blood pressure screening for all employees. On my way to lunch I thought I would stop and see how well I was doing. Not being overweight and being very active, I assumed it would be perfectly normal. There was the stress of work, but I could handle that. The nurse took my pressure once and then did it again. She looked at me with alarm and told me that my blood pressure was 170/110. She sent me immediately to the company hospital. I had no symptoms. I was healthy. There had to be a mistake. But, there wasn’t.

The doctor confirmed the findings and made me lie down and relax while he arranged for an immediate appointment with a physician I had seen earlier in the year. I was placed on medication that very day. I had to have the pressure checked and rechecked and as the medication kicked in and the pressure returned to a more normal level, I began to relax. The doctor had told me to watch my intake of sodium because salt causes the body to retain fluid that causes blood pressure to rise. My wife and I began to read labels and where amazed by the amount of sodium in prepared foods. Bless her heart; my wife stopped cooking with salt all together. She found other herbs and seasonings to flavor our food. I never knew the difference. Lucky me. But, with the aid of medication which I take religiously and an improved knowledge about how and what to eat, my blood pressure has returned to normal. I also retired, and the loss of stress can’t have hurt.

Edith, age 58
When I was young, my thyroid failed. One of the side effects of that was a very low blood pressure. I remember one day going to the drug store and while I waited for a prescription for one of my children, I sat down at the blood pressure machine. When the reading showed up on the screen it said 60/40. I was used to that sort of thing, but the druggist behind me said, "Edith, I want you to go home and call your doctor and tell him what that machine just said." I laughed and said, "Oh Ed, no one ever dies of low blood pressure." He looked at my very seriously and replied, "Edith, everyone dies of low blood pressure." I hadn’t ever thought of it that way.

Sometime after my 50’s began, I was at a routine check up and my blood pressure was elevated. Not dangerously, but above normal. Two visits later, it was extremely high. My mother was dying and I assumed it was just the stress. But, my mother was dying of Renal Failure brought on by years of hypertension. Whatever the cause, it wasn’t something I should mess around with. The doctor put me on medication and the numbers came back down. I had a few side effects, but they quickly disappeared. Now, every day begins with that little pill. But, I also did some things for myself. I bought a CD that has healing music on it and I lie down and rest for an hour each day and listen to it. It relaxes me and I think that has to be good. I substitute Mrs. Dash products for salt, and gave up regular soda for Diet Rite which has no sodium. I read labels. And make wise choices.

A Note on End-Stage Renal Disease or (ESRD)

ESRD (also called end-stage kidney disease) is a condition closely related to high blood pressure. ESRD morbidity rates vary dramatically among different age, race, ethnicity and sex population groups. Morbidity rates tend to increase with age, then fall of for the oldest age group. The largest 5-year age group for incidence is ages 70-74; for prevalence, it’s ages 65-69.

  • In 2000 an estimated 96,200 new cases of ESRD were diagnosed.
  • The incidence of reported ESRD therapy has almost doubled in the past 10 years.
  • 378,862 patients were being treated for ESRD by the end of 2000.
  • More than 13,500 kidney transplants were performed in 2000.
  • Diabetes continues to be the most common reported cause of ESRD.