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As a neurologist at Yale New Haven Health and an assistant professor with Yale School of Medicine, Rachel Forman, MD, knows only too well why high blood pressure is often called a “silent killer.”
“Eighty to 90 percent of strokes are preventable, and the biggest cause of stroke is high blood pressure,” Dr. Forman said.
Considering that strokes can kill and or cause serious disabilities for many people, why is the danger posed by high blood pressure underestimated?
“People often don’t know they have it; they usually don’t feel sick,” Dr. Forman said. “I often see patients for the first time because they’re having a devastating stroke, but they’ve had high blood pressure for years, and it could have been managed, both with medications and lifestyle changes.”
High blood pressure is a primary or contributing cause in more than 500,000 deaths each year in the United States, according to the US Food and Drug administration. Also called hypertension, high blood pressure can damage the body’s internal systems and organs, with few if any early warning signs.
In fact, the issue of high blood pressure is so far off the health radars of most people that only about one in four with hypertension keep it under control. “This means people are unknowingly putting at risk their heart, brain, kidneys and other organs,” Dr. Forman said. She added that hypertension can and does lead to heart attack, heart failure, stroke, kidney disease, blindness and cognitive decline.
“The single most important thing people can do is get their blood pressure checked and then talk to their healthcare professional about next steps,” Dr. Forman said.
“A healthy blood pressure reading is one of the keys to overall heart health, and there are several steps one can take to maintain a good level – at 120/80 or lower,” said Yale Medicine interventional cardiologist Brian Cambi, MD, of the YNHHS Heart and Vascular Center. “These include a healthy diet and exercise which can go a long way to help prevent conditions like stroke, which can be caused by high blood pressure.”
What causes high blood pressure?
Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps blood. High blood pressure is a disease in which blood flows through vessels (arteries) at higher-than-normal pressure. “That added pressure in the arteries can result in a blood clot breaking off into an artery of the head or neck, which then prevents blood from getting to the brain,” Dr. Forman explained. “We call that an ischemic stroke.
“High blood pressure can also cause a hemorrhagic stroke, which means the same artery breaks apart and starts bleeding, which also prevents normal blood flow from reaching the brain,” Dr. Forman said. “When the brain is denied blood that is rich in oxygen and nutrients, brain cells will begin to die off very quickly. This can cause serious complications up to and including death.”
What are normal blood pressure readings?
Blood pressure is measured with two numbers. For example, normal, healthy blood pressure is 120/80, or lower. The first, or top number, is the pressure in your blood vessels when your heart beats, called systolic pressure. Diastolic pressure – the lower of the two numbers – is the force of blood in your arteries when the heart is relaxed between beats.
Your blood pressure is considered high (stage 1) if it reads 130 to 139 mmHg/80 to 89 mmHg. Stage 2 high blood pressure is 140/90 or higher. If you get a blood pressure reading of 180/120 or higher more than once, seek medical treatment right away. A reading this high is considered a “hypertensive crisis.”
Readings between 120/80 and 129/89 are considered pre-hypertension. People with pre-hypertension do not have ideal blood pressure, but it is not yet called “high” blood pressure.
How to lower blood pressure
Treatment of high blood pressure often starts with lifestyle changes, including decreasing salt in your diet, losing weight if necessary, quitting smoking, cutting down on alcohol use, and engaging in regular exercise.
In addition to lifestyle changes, medications are often used to lower blood pressure. There are several types of medications that treat high blood pressure with each type of medication having benefits and risks that should be carefully weighed by you and your healthcare professional. When taking blood pressure medication, Dr. Forman emphasized that it is particularly important to take it consistently to ensure the best results.
