Hypertension, also known as high blood pressure, is a silent killer that lurks among us, helping to claim millions of lives every year.
According to a new study published in The Lancet, the number of kids under age 19 who have high blood pressure has doubled worldwide since 2000. The rest of the population isn’t faring much better either: In the US, nearly half of Americans have hypertension — twice the rate from a generation ago.
That might mean you, too. And I’m sorry, but the news gets worse: Thanksgiving is the disease’s favorite time of year. It seems our social calendar and our food supply are conspiring to give each of us this too-often-overlooked condition — with potentially deadly consequences.
Only about half of the people who have hypertension have it under control, a figure that has been declining over the past 10 years, even though this is among the most tractable public health problems that we have. With better monitoring, lifestyle modification, and medication, it is possible to reduce someone’s high blood pressure.
But the problem is, many of the people who have it, especially younger patients, are totally unaware.
What you can do to manage your blood pressure
Hypertension, like many diseases, does have a genetic or hereditary component — if you have a family history, you are at higher risk — but if you regularly eat too much sodium and do not get enough exercise, you’re putting yourself at risk, too. A traditional Thanksgiving dinner, for example, can easily have more sodium than any person is supposed to eat in an entire day. And lying on the couch for the entire afternoon after that meal isn’t helping either.
Luckily, Thanksgiving only comes once a year. But too many Americans eat salt-rich diets and stay sedentary the rest of the year, too.
You can change that. Doctors have come up with what they call the DASH (Dietary Approaches to Stop Hypertension) diet as the best strategy for managing your blood pressure. You should eat a lot of fruits and vegetables, beans and nuts, and whole grains. You should try to eat foods that are high in fiber and potassium (which helps your kidneys filter sodium); you, of course, want low-sodium and low-fat foods too. I typically buy the no salt added or reduced sodium options for, for example, chicken broth. Red meats and processed foods, both of which are linked to hypertension, are your enemies.
In the end, you want to eat between 1,500 and 2,000 milligrams of sodium in a day and no more. You could drink less alcohol and less caffeine, both of which raise your blood pressure temporarily, as well.
On the exercise front, working out is not always a foolproof weight-loss strategy — but it is proven to be effective in lowering your blood pressure. Walking, jogging, swimming, cycling, and even dancing are all good for you. But regardless of what you’re doing, your goal should be about 150 minutes per week. It is best to combine that classic “cardio” exercise with strength training (which both lowers blood pressure on its own and makes your aerobic workouts more effective) and even stretching and breathing routines like yoga, which can help regulate your heart and lead to better sleep. All of these things can help to keep your blood pressure down.
There is also a wide range of existing blood pressure medications, which can be very effective but do come with some risks, such as blood thinners that can cause excessive bleeding. We are entering a new age of medicine, however, in which wearable tech that allows patients to monitor their blood pressure minute by minute and GLP-1s are likely to become more commonplace.
Apple Watch rolled out a blood pressure monitoring capability this fall: You can turn on hypertension notifications, and your device will notify you if it detects consistently high blood pressure. The wearable tech company Oura Labs is working on something similar. Right now, the best way to monitor at home is to buy your own blood pressure cuff like the one at your doctor’s office; my own physician pointed me to the Omni units to monitor my blood pressure at home. They can cost as little as $40, and if you have an FSA or an HSA, it is an eligible expense.
But this can be a little inconvenient — you have to sit down, take a few minutes to get your blood pressure to “normal,” and then affix the cuff correctly to ensure you’ll get an accurate reading. Having the same capability walking around with you on your wrist at all times would be a boon, much like continuous glucose monitoring has helped people better manage their diabetes.
These are effectively brand new prototypes, however. As Apple itself warns, they should not be used to diagnose hypertension or to monitor and control it. Not everybody who has high blood pressure will have it detected by the Apple Watch. And it may not even be able to detect serious cardiac events, such as a heart attack.
Likewise, the new class of GLP-1 weight-loss drugs has shown modest benefits for hypertension, as well as reduced risk of heart attack and stroke. But that science is preliminary. We still have a lot to learn about those drugs and, even if they are effective, they would work best in tandem with a blood pressure-conscious diet and exercise routine.
The good news is that high blood pressure is a health problem you can do something about. You just have to figure out whether you have a problem in the first place.
You can read Dylan's full story, including much more on why hypertension is so dangerous and how it can fly under the radar, on the Vox site here.
