The hidden burden of high blood pressure

A condition like high blood pressure is sneaky. You don't feel it, and it generally doesn't cause any outward signs or symptoms. Yet it silently damages blood vessels, the heart, kidneys, and other organs.

High blood pressure — also known as hypertension — isn't a disease. It is a sign that something is wrong in the body. In some people with hypertension, the culprit is a narrowing of the arteries supplying the kidneys (renal artery stenosis), or an overactive thyroid gland (hyperthyroidism) or adrenal glands (aldosteronism). When these are treated, blood pressure drops back to normal. More often, though, doctors find no underlying cause for high blood pressure. This condition is called essential hypertension.

Effects on health

High blood pressure imposes an up-front burden in people who know they have it and who are working to control it. It adds to worries about health. It alters what you eat and how active you are, since a low-sodium diet and exercise are important ways to help keep blood pressure in check. Some people need medication and may need to take one or more pills a day, which can be a costly hassle.

There are long-term consequences, too. High blood pressure contributes to the development of stroke, heart attack, heart failure, and kidney disease. In the United States, it directly accounts for about 60,000 deaths a year and contributes to another 300,000.

Then there are hidden burdens. Perhaps because of all the ways hypertension interferes with health, the average life span for people with it is five years shorter than it is for those with normal blood pressure. A team of Spanish researchers has tallied up another hidden drain of high blood pressure — its effect on survival and rehospitalization after someone is admitted to the hospital for a heart problem.

These researchers looked at the 1,007 men and women admitted to the hospital over a 10-month period for any potentially heart-related problem. These ranged from chest pain and fainting to heart attack, heart failure, atrial fibrillation, and pericarditis. In this group, 69% had been diagnosed with high blood pressure before being admitted to the hospital. Each person was followed for one year. At the end of that time, 17% of those with high blood pressure had died, compared with 9% of those with normal blood pressure. Rehospitalization for a cardiac problem followed the same pattern: 31% of those with high blood pressure, and 18% of those without (American Journal of Cardiology, published online, Aug. 24, 2011).

Keeping the burden at bay

But there is actually good news about high blood pressure: there is a lot a person can to do help keep it in check, and even prevent it from occurring in the first place.

How? The National Heart, Lung, and Blood Institute; the Centers for Disease Control and Prevention; and the American Heart Association offer these recommendations:

• Achieve and maintain a healthy weight for your height.
• Exercise regularly.
• Eat a diet that is rich in fruits, vegetables, and whole grains.
• Limit sodium intake to under 2,300 milligrams a day (one teaspoon of salt), and get plenty of potassium (at least 4,700 mg per day) from fruits and vegetables.
• Drink alcohol in moderation, if at all.
• Reduce stress.
• Monitor your blood pressure regularly, and work with your doctor to keep it in a healthy range.