Astonishing as it may seem, nearly half of Americans ages 20 and older — more than 122 million people — have high blood pressure, according to a 2023 report from the American Heart Association.
And even if your numbers are normal right now, they’re likely to increase with age; more than three-quarters of Americans age 65 and older have high blood pressure.
Also known as hypertension, high blood pressure is a major risk factor for heart disease and stroke.
Our research found that most Americans don’t know the normal or healthy range for blood pressure — and yet, strikingly, they think they do. And this is a source of serious concern.
We are a health communication expert and a cardiologist. Working with our health communications collaborators, we surveyed more than 6,500 Americans about their knowledge of blood pressure.
They were recruited as part of the Understanding America study, a nationally representative sample of US residents.
In our new study, published in January 2023, we found that 64% expressed confidence in their understanding of blood pressure numbers, but only 39% actually knew what normal or healthy blood pressure is.
False Trust, Deadly Consequences
Such false confidence can be harmful as it can prevent people from seeking treatment for their high blood pressure. After all, if you think it’s normal, why bother telling your doctor about your blood pressure?
Part of the reason for this overconfidence starts in the doctor’s office. Typically, a nurse brings a blood pressure cuff, straps it to your upper arm, and takes a reading. The nurse can announce the result, remove the cuff and save it for the doctor.
When the doctor arrives, the session can very well move on without a word about the blood pressure reading.
This probably happens because your doctor wants to focus on how you feel and why you’re there. But as a result, you may leave your appointment thinking your blood pressure is fine, even if it isn’t.
About 70% of Americans will suffer from high blood pressure in their lifetime. Moreover, only 1 in 4 hypertensive patients have their blood pressure under control. And because high blood pressure usually has no symptoms, you can have it and not know it.
To reduce your risk of heart attacks and strokes, it is essential to understand your blood pressure readings. This is especially true for patients with conditions such as heart disease, kidney disease, and diabetes.
What do the numbers mean
Blood pressure is indicated by two digits. The first number is your systolic blood pressure; it measures the pressure in the arteries when the heart beats. The second number, your diastolic blood pressure, measures the pressure in your arteries between heartbeats.
Normal or healthy blood pressure is below 120/80 millimeters of mercury (mm Hg) for adults.
It’s a unit of measurement that originated with early blood pressure monitors, which looked at how far your blood pressure could push a column of liquid mercury. For most patients, a drop tends to be better.
Stage 1 hypertension, which is the lower stage of high blood pressure, starts at 130/80.
Stage 2 hypertension, which is the most severe stage of high blood pressure, starts at 140/90.
These two numbers are critically important, because every 20 millimeters of mercury increase in systolic blood pressure or 10 millimeters of mercury increase in diastolic blood pressure doubles the chances of dying from a heart attack or stroke.
10 tips for healthier blood pressure
To avoid false confidence, ask about your blood pressure at every doctor’s visit and find out what the numbers mean. If your blood pressure is above the normal or healthy range, the American Heart Association recommends the following 10 tips.
- Discuss with your doctor. If your blood pressure is high, ask your doctor about strategies to lower it and how you can monitor your blood pressure at home.
- Eat a heart healthy diet. Vegetables, fruits, whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes, and olive oil are all good for your heart. Red meat, saturated and trans fats, and ultra-processed foods are unhealthy for your heart.
- Reduce your salt intake, which increases blood pressure. Dietary Guidelines for Americans recommend no more than 2,300 milligrams of sodium a day – that’s less than a teaspoon – but the US Food and Drug Administration reports that the average American consumes about 3. 400 milligrams per day, which is about 50% more than recommended. Even if you don’t add salt to your meals, ultra-processed foods can still consume too much. A serving of canned chicken noodle soup contains 680 milligrams of sodium. A McDonald’s Big Mac contains 1,010 milligrams of sodium.
- Limit your alcohol intake. Whether it’s beer, wine or spirits, alcohol raises your blood pressure. It’s best not to drink alcohol, but if you do, stick to the limits recommended by the Dietary Guidelines for Americans. For women, it’s at most one drink a day. For men, it’s a maximum of two glasses a day. A drink is 12 ounces of beer, 4 ounces of wine, 1.5 ounces of 80 spirits or 1 ounce of 100 spirits.
- Be more physically active. Just two and a half hours of physical activity per week can help lower blood pressure. For example, it’s a 30-minute walk five days a week. You can also switch up your physical activity by swimming, lifting weights, doing yoga, or going dancing.
- Maintain a healthy weight. Even losing a few pounds can help manage high blood pressure in overweight people. Ask your doctor about a healthy approach to weight loss.
- Manage stress, which is bad for your blood pressure. While stress relief doesn’t always lower blood pressure, reducing your stress levels can help you feel better. The Mayo Clinic recommends several ways to manage stress, including learning to say no sometimes, spending time with family and friends, and meditating.
- If you smoke, vape or both: Stop now. Both are bad for your heart and blood vessels and contribute to high blood pressure. Quitting smoking can reduce your risk of heart disease to about the same as people who have never smoked. And the benefits of quitting smoking start right away. A recent study found that after just 12 weeks, people who quit smoking had lower blood pressure than when they were still smoking. The Centers for Disease Control and Prevention has recommendations for programs and medications that can help you quit smoking.
- Take medication, which is often recommended for people with stage 2 hypertension and for some people with stage 1 hypertension, including those who also have heart disease, kidney disease, or diabetes . Most patients need two to three medications to lower blood pressure to normal or healthy levels. A recent meta-analysis demonstrated that lowering systolic blood pressure by 5 mm Hg with medication reduces the risk of major cardiovascular events by approximately 10%, regardless of baseline blood pressure or prior diagnosis of cardiovascular disease.
- Track your blood pressure at home. The American Heart Association recommends an automatic, validated cuff-style monitor that goes on your upper arm. A record of readings taken over time can help your doctor adjust your treatments as needed.
High blood pressure is a silent killer. Being proactive and knowing your numbers can save your life.
Wändi Bruine de Bruin, Professor of Public Policy, Psychology and Behavioral Sciences, USC Sol Price School of Public Policy, USC Dornsife College of Letters, Arts and Sciences and Mark Huffman, Professor of Medicine, Washington University in St. Louis
This article is republished from The Conversation under a Creative Commons license. Read the original article.