By Lisa Collier Cool
America’s doctors are doing an appallingly poor job of treating high blood pressure, the world’s leading cause of death and disability, according to a shocking new report from the Centers for Disease Control and Prevention.
The CDC reports that of the 67 million Americans with high blood pressure, 36 million don’t have their condition under control, even though the majority of them see a doctor at least twice a year, have health insurance, and take medication.
That’s alarming because high blood pressure is a stealthy assassin that ranks as a leading risk factor for stroke and heart disease—conditions that kill nearly 1,000 Americans a day. Uncontrolled high blood pressure can also lead to kidney failure, blindness, and memory loss.
Deadly Medical Neglect
“The CDC report underscores a deadly failure of standard medical care: All too often, healthcare providers ignore or undertreat high blood pressure—putting patients’ health or lives at risk from this silent killer,” says Bradley Bale, MD, Medical Director of the Heart Health Program at Grace Clinic in Lubbock, Texas.
Dr. Bale’s research points to “therapeutic inertia” as a key reason why high blood pressure (140/90 or higher) often remains out of control even when patients seek medical care. In a paper published in Journal of the National Medical Association, he reports that doctors often give up if the first blood pressure medicine they prescribe doesn’t help.
In fact, in one retrospective study, only 13 percent of healthcare providers made medication adjustments in patients with uncontrolled high blood pressure. The researchers found that reducing “therapeutic inertia” by just 20 percent would result in improved blood pressure for up to 66 percent of the patients studied.
An Often Ignored, But Dangerous Blood Pressure Problem
The CDC report doesn’t even mention another 67 million Americans who have a dangerous blood pressure condition called prehypertension, defined as systolic blood pressure (the top number) between 120 and 139, or diastolic pressure (the bottom number) between 80 and 89. If one number is in this range and the other is lower, you still have prehypertension.
“If your blood pressure is in this range, there’s a very good chance that you’ve been told it’s fine,” reports Dr. Bale.
Actually, prehypertension raises stroke risk by 55 percent and more than triples the risk of heart attacks. It’s important to get your blood pressure under control once it exceeds 120/80, rather than waiting until it hits 140/90, the level defined as hypertension, emphasizes Dr. Bale.
What Should Doctors Be Doing to Stop a Silent Killer?
If your blood pressure is 120/80 or above, it’s important for your healthcare provider to find out why you have abnormal blood pressure, says Dr. Bale. “The most common—and often overlooked–cause of elevated blood pressure is insulin resistance (IR), which is also the root cause of type 2 diabetes.”
As I reported recently, insulin resistance also raises risk for Alzheimer’s and other forms of dementia. About 140 million Americans have this blood sugar disorder, in which the body produces insulin, but doesn’t use it correctly. IR is most likely to strike people who are overweight (or have a large waist) and sedentary.
Another surprising cause of high blood is obstructive sleep apnea (OSA), a sleep disorder that affects 18 million Americans, 90 percent of who are undiagnosed. This condition is marked by bouts of interrupted breathing during sleep, which strains the heart and blood vessels due to sudden drops in oxygen. Symptoms include loud snoring, unexplained daytime drowsiness, and difficulty paying attention.
What can you do to prevent high blood pressure?
Make sure to get your blood pressure numbers. As I reported previously, it’s important to take blood pressure readings in both arms. A difference in systolic blood pressure (the top number) between arms could indicated narrowed blood vessels in one side of the body, which may lead to cardiovascular disease.
There are many steps to take to either reduce hypertension or prehypertension, or to prevent it:
- Maintain a healthy weight. If you’re overweight, shedding even a few pounds can reduce your blood pressure.
- If you smoke, take steps to kick the habit. Abstaining from tobacco cuts risk for many diseases, as well as high blood pressure. Even secondhand smoke can raise your blood pressure, so avoid smoky environments.
- Exercise regularly. Physical activity lowers your heart rate, so your heart doesn’t have to work as hard with each contraction—or put as much pressure on your arteries.
- If you drink alcohol, limit yourself to no more than one drink a day if you are female, or two drinks a day if you are male.
- Eat a healthy diet that is low in sodium and high in fruits, vegetable and potassium. Potassium-rich foods include winter squash, sweet potatoes, potatoes, broccoli, cantaloupe, bananas, white beans, lentils, milk, yogurt, halibut, salmon, chicken, tuna and pork tenderloin, as well as pistachios and raisins.