Diabetes, Heart Disease, & Stroke - NIDDK
How Hypertension Significantly Raises The Risk Of Death From Heart Disease
High blood pressure has been identified as the leading risk factor for death in Australia.
Research published today in the journal PLOS ONE reports that high blood pressure, also known as hypertension, was the leading risk factor for cardiovascular deaths and all cause deaths in Australia over the past 30 years.
Experts say those findings are likely to be similar in the United States.
"This is consistent with what we already know in the United States. Hypertension, when inadequately treated, increases an individual's risk for coronary artery disease, heart failure, kidney failure, stroke, peripheral artery disease, dementia, aortic aneurysms, and that's just to start," Dr. Parveen Garg, a cardiologist at Keck Medicine of USC in California who wasn't involved in the research, told Medical News Today. "Considering the prevalence of hypertension, the under-recognition of this condition, the inadequate treatment of this condition, and health risks it poses, we can expect similar findings in the U.S."
Researchers noted that Australia lags behind other higher-income countries in hypertension management.
They said dietary factors as well as use of tobacco were among the top risk factors.
Experts based in the United States say although the study looked only at the Australian experience, the data is helpful for clinicians around the world.
"As a global cardiovascular community, we are committed to improving health for everyone. To that end, more knowledge is power. Collaborative efforts to understand risk factors, interventions, and outcomes can certainly inform approaches both in the U.S. And globally," Dr. Megan Kamath, a cardiologist at UCLA Health in California who wasn't involved in the research, told Medical News Today.
"The latest data from the [Centers for Disease Control and Prevention] suggests that we have significant room for improvement in controlling hypertension," she added. "Only about 1 in 4 adults in the U.S. Have controlled hypertension. One of the biggest challenges with hypertension is that it is often silent and people don't know that they have it until they have an event of some sort. We need to continue focusing efforts on prevention first, early detection, and then follow up to maintain control in order to have improvement in our population health-based efforts."
In the United States, hypertension is considered a blood pressure reading at or above 130/80mmHg.
Stage two hypertension is considered a reading at or above 140/90mmHg.
A normal blood pressure is less than 120/80 mmHg.
Nearly half of U.S. Adults have hypertension. That's close to 120 million people.
Only 22% have their hypertension under control. Another 45% of U.S. Adults with uncontrolled hypertension have a blood pressure reading of 140/90 mmHg or higher. That amounts to 37 million people.
Data from the Centers for Disease Control and Prevention suggests that in 2021, hypertension was a primary cause or contributing cause of nearly 700,000 deaths in the United States.
"The way I would kind of think about hypertension is we use the term 'primordial risk factor' and what we mean by that is that it's a risk factor that can result in diseases that may have even a greater consequence, like coronary heart disease, or stroke," Dr. Manoj Kesarwani, an interventional cardiologist at UC Davis Health in California who wasn't involved in the research, told Medical News Today. "And so in that context, controlling hypertension will help prevent patients from having cardiovascular disease, which is the number one killer in the United States."
The experts who spoke with Medical News Today say that controlling hypertension is a challenge not just on an individual level but at a population level too.
"On an individual level it can be difficult to control blood pressure due to poor lifestyle choices, limited education, and poor adherence or follow up with medical recommendations once a diagnosis has been made. On a population level, there are several more challenges, including access to care and social determinants of health playing into the difficulty of controlling blood pressure at this level," Kamath said.
Adding to the challenge is the reality that most people are unaware they may be impacted by hypertension.
"Hypertension is not in the mind and consciousness of everyone, Kesarwani said. "For example, I had a patient that I took care of in the hospital [who had] suffered a stroke. He was only 38 years old and didn't know that he had poorly controlled hypertension. And you think, well, was there an opportunity to intervene?"
Limiting alcohol intake, not smoking, maintaining a healthy weight, and being physically active can help prevent hypertension and help manage it.
However, experts say despite hypertension being a leading risk factor, people don't always understand how serious it can be and how important management is.
"This disease is referred to as a 'silent killer' and, well, that really summarizes the problem, Garg said. "Hypertension is asymptomatic. Most people do not know they have it. And when they are informed they do not understand the need to fix it as they feel 'fine.' This condition is chronic and it often takes decades for overt disease to manifest. An emphasis on the health risks of hypertension to individuals when they are in earlier stages and a greater urgency to treat this with improved lifestyle measures and medications are vital."
Data from the World Health Organization shows that nearly 1.3 billion adults around the world have hypertension and nearly half have no idea they are living with the condition.
"Hypertension is really a global phenomenon. We're seeing it in Australia. We're seeing it in the United States. We're seeing it in countries like Mexico. You're not able to escape hypertension, regardless of where you live," Kesarwani said.
How High Blood Pressure Can Raise Your Risk Of Heart Disease, Death
The authors of a new study published in the journal PLOS ONE say that high blood pressure has been the top risk factor for death among the Australian population for the past 30 years.
Additionally, it has been the primary factor leading to deaths from cardiovascular disease.
According to the American Heart Association, cardiovascular disease includes various conditions affecting the heart and the blood vessels, such as heart attack, stroke, heart failure, heart rhythm abnormalities, and heart valve problems.
The U.S. Centers for Disease Control and Prevention explains that high blood pressure is a known risk factor for cardiovascular disease.
It can damage arteries over time, making them less flexible. This reduces the flow of blood and oxygen to the heart. It can also cause the arteries in the brain to burst or become blocked.
The researchers, however, note that despite this knowledge, national health plans in Australia have not always made this condition a priority.
They felt that studying how high blood pressure compares in relation to other cardiovascular disease risk factors could help the country make more effective healthcare policy decisions.
To study the issue, the team from The George Institute for Global Health and UNSW, Sydney, looked at epidemiological data from the Global Burden of Disease (GBD) study, which includes data from 204 countries, including Australia, related to almost 400 diseases and 87 risk factors.
Data from 1990 to 2019 was used to determine the main risk factors for deaths from all causes and cardiovascular disease.
When they analyzed the data, they found that high blood pressure's contribution to death declined from about 54% to 44%.
However, it remained the top risk factor in both all-cause and cardiovascular disease-related deaths.
Other top contributors included diet and tobacco use.
There were also differences related to age and sex. In particular, in men between the ages of 25-49, high blood pressure contributed more to deaths from stroke than in other groups.
Dr. Hoang Nguyen, a board certified interventional cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, California, who was not involved in the study, stressed the importance of accurately assessing your blood pressure.
"Ironically, blood pressure readings in the physician's office are often inaccurate; falsely elevated due to the stress of being in the physician's office or the stress of getting there," he explained.
"Blood pressure should be measured at rest (patient should relax for 5 minutes) while seated in a chair with uncrossed legs," Nguyen added. "An arm cuff and not a wrist cuff should be used to measure blood pressure."
Additionally, he advises measuring your blood pressure at home and keeping a log to share with your doctor.
"Once high blood pressure is verified, we can employ lifestyle changes to lower blood pressure, such as regular exercise," he said.
Nguyen remarked that weight loss can also be helpful in lowering blood pressure, to the point that you may no longer require medications. "Just losing 5 lbs. Can lead to a significant reduction in blood pressure," he noted.
Limiting alcohol consumption and quitting smoking can also help, Nguyen stated, adding that smoking cessation also has other benefits for cardiovascular health.
Additionally, getting good sleep and avoiding salty foods can help lower your blood pressure, he said.
Dr. Shannon Winakur, a cardiologist at the University of Maryland St. Joseph Medical Center in Towson, Maryland, who was not involved in the study, added to the above by suggesting that people also consider whether they have any issues with pain.
"Pain management — whether a result of a chronic condition or injury — is important, as pain is a stressor that can increase your blood pressure," she stated.
Winakur noted that there is a significant overlap between what you can do to reduce your risk of high blood pressure and what you can do to reduce your cardiovascular disease risk.
One additional suggestion she made to reduce the risk of both is moving more.
"The 'official' recommendation is 150 minutes per week of moderate physical activity," she said, "but I tell patients that anything is better than nothing."
Winakur also advises not limiting yourself by thinking that exercise has to be something like running or a fitness class.
'You can dance in your kitchen, walk your dog, park farther away from the store, anything that encourages more movement…By building opportunities for moving more into your regular routines, you'll be gradually strengthening your heart," she explained.
When it comes to what you eat, "A diet that consists mostly of vegetables and is low in saturated fat (animal fat, such as beef, pork, ham, bacon, and in dairy products) and low in refined carbs and sugars (as in breads, pastas, and sweets, for example), with small portions of lean meats, fish, and complex carbohydrates can contribute to improved heart — and overall health," Winakur said.
She further advises eating food as close as possible to its natural state.
"You don't see a loaf of bread or chickpea pasta in the wild," she noted.
Winakur also suggests seeing a doctor regularly and having basic testing like blood pressure, blood sugar, and cholesterol levels.
"Being aware of any potential issues early on can spur a conversation with your care provider about things you can do to stay your healthiest," she said.
Finally, Winakur says taking steps to deal with stress is important.
"Use healthy methods for managing stress by doing things like getting enough sleep, moving in some way daily, using meditation regularly, limiting the use of alcohol, and limiting your exposure to the news and screens (TVs, tablets and cell phones) of any kind when you need to," she concluded.
High blood pressure is a known risk factor for cardiovascular disease.
However, an Australian study has found that high blood pressure remains the leading risk factor for premature death from all causes, including cardiovascular disease, in that nation.
Experts advise taking steps to reduce your blood pressure by improving your diet, exercising, stopping smoking, reducing alcohol intake, and reducing stress.
This, in turn, will reduce your risk of cardiovascular disease and death.
19 For A Cure: New Hypertension Clinic Serving A Growing Number Of People
CINCINNATI (WXIX) - Hypertension is a condition that can build slowly over time without clear symptoms until it's far too late.
A new clinic in the Tri-State is serving a growing number of people dealing with hypertension. Dan Wells has more on the clinic in this 19 For a Cure segment.
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