High blood pressure is easy to diagnose, but many people who have it are unaware.
More than two-thirds of the people who have hypertension, the medical term for high blood pressure, do not have it under control, according to a study by the Institute of Medicine. An estimated 73 million people in the United States — 1 in 3 — have high blood pressure.
Somerset Hospital cardiologist Dr. V. Krishnan Nair said hypertension is known as a silent killer.
"Most of the time it is a silent illness, a silent killer, because there are no symptoms," he said. "Not everyone goes annually to a doctor. Moderate hypertension will not show symptoms. Very high hypertension can cause headaches or symptoms in other organs."
Blood pressure is measured by two numbers. The systolic blood pressure, the upper number, is the measure of the heart pumping. The diastolic reading, the bottom number, is a measure of the heart at rest. A blood pressure of 120/80 is normal. A blood pressure consistently over 140/90 is considered high. The National Institutes of Health lowered the levels in 2003. Prior to the change, it was believed that the top number could be as high as 160.
Men are more likely to have high blood pressure than women. High blood pressure in children is a signal of another illness: kidney disease or adrenal gland disease.
People should have blood pressure checked beginning at age 18. Those who have blood pressure readings of 120/80 should have it checked by a medical professional at least every two years. Those with prehypertension, a reading of 120 to 139 over 80 to 89, should have it checked every year. Those with hypertension should follow the physician's orders.
"Some people are noncompliant, they know they have high blood pressure but they don't take their medication because of the costs and side effects," Nair said. "The most important thing is to make lifestyle changes to prevent high blood pressure."
People can lower their blood pressure by losing weight, exercising, cutting back on salt and boosting potassium levels by eating more fruits and vegetables. Obesity is one of the key reasons for the epidemic of high blood pressure, but smoking and excessive alcohol consumption add to the problem. The main issue is metabolic syndrome: a big waistline that causes your blood pressure to go up, your glucose to go up, causing diabetes, and your cholesterol to go up, causing heart disease.
"Alcohol is a double-edged sword," he said. "Drinking in moderation can ameliorate blood pressure. Excessive alcohol consumption increases it. If you cut down your BMI (body mass index), it reduces blood pressure by 5 to 10 millimeters of mercury by itself. Stop smoking. Take a brisk walk 30 minutes a day. If you go to the DASH (Dietary Approaches to Stop Hypertension) diet, it will reduce it another 5 to 10 millimeters of mercury."
Illegal drugs, such as cocaine and amphetamines, also raise blood pressure. Certain chronic conditions, such as diabetes, kidney disease and sleep apnea, may increase blood pressure. Sometimes pregnancy contributes to high blood pressure. High blood pressure leads to heart attacks, strokes, kidney disease and eye problems. An estimated 1 billion people in the world are expected to have high blood pressure by 2030.
"Treatment costs billions of dollars. It is a very costly problem," Nair said. "It is easily preventable. Think of it as a deficit reduction. Imagine how much the treatment cost will go up as more people have hypertension."