Cardiovascular disease is the leading cause of avoidable premature death and disability around the World. Current statistics are that cardiovascular disease, primarily heart attacks and stroke, account for over 900,000 deaths annually within America alone, globally that number jumps to over 10 million deaths.
In America, high blood pressure affects about 45% of adults. During the 1970s, only about 50% of patients were aware of their hypertension and around 50% of those were being actively treated. Fast forward to today and that hasn’t changed too much with only 54% being aware of their high blood pressure, 40% actively being treated and 21% being actively controlled.
Heart attack and stroke
High blood pressure/uncontrolled hypertension is a serious risk factor for the likelihood of experiencing a heart attack or stroke. There are steps that people can take which involve therapeutic lifestyle changes to their dietary choices and exercise routines to complement adjunctive drug therapies that have been shown to help prevent and manage cardiovascular disease.
To add to this issue, metabolic syndrome is a primary risk factor for heart attacks and stroke in America, which is now the heaviest society in the World. According to the NHLBI, and NIH, 1 in 3 American adults has metabolic syndrome. Making healthful lifestyle changes such as losing weight, moving more, and cutting down on salt and sugar intake have been shown to be beneficial for metabolic syndrome as well as managing blood pressure.
Sounding an alert
Although there are preventive measures to be taken, the rates of hypertension remain grim, prompting researchers to sound an alert to healthcare providers reminding them that the “old silent killer” is still alive and thriving in a commentary published in The American Journal of Medicine from Florida Atlantic University’s (FAU) Schmidt College of Medicine and colleagues.
“Health providers should be aware that uncontrolled hypertension is one of the most common, serious, and increasing conditions in their patients,” said Stacy Rubin, M.D., senior author and an assistant professor of medicine, at FAU Schmidt College of Medicine. “Health providers urgently need to control blood pressure and should be mindful that sudden cardiac death accounts for 50% of deaths from cardiovascular disease and is the first symptomatic event in about 25% of cases. Moreover, for 76% of stroke patients, the initial presenting symptom is the stroke itself.”
Now and then
Before the Hypertension Detection and Follow-Up Program, a landmark study conducted in the 1970s in the U.S., around 50% of patients were aware of their high blood pressure, and only 50% of those were being actively treated. Of that group, only 50% received effective treatment, meaning that only one-eighth of all patients were effectively treated.
Using today’s numbers, these figures show that 54% are aware of their high blood pressure, 40% are actively being treated and 21% are being actively controlled.
Management and prevention
Guidelines have been developed worldwide which all tend to emphasize the need for strict control. According to the latest guidelines from the American Heart Association and the American College of Cardiology, healthy individuals should have a systolic blood pressure of 130 millimeters of mercury (mmHg) or less and a diastolic blood pressure of 80 mmHg or less.
“With these latest definitions, hypertension affects about 45% of the U.S. adult population,” said Panagiota “Yiota” Kitsantas, Ph.D., co-author and professor and chair of the Department of Population Health and Social Medicine, FAU Schmidt College of Medicine. “Another clinical challenge is metabolic syndrome, which includes central adiposity, high triglycerides, low high-density lipoprotein cholesterol, elevated fasting blood glucose and hypertension.”
“For patients with metabolic syndrome, we believe that angiotensin-converting enzyme or ACE inhibitors or their more potent next-generation drugs, the receptor blockers, are the first drug of choice,” said Charles H. Hennekens, M.D., Dr.PH., co-author, and corresponding author, the first Sir Richard Doll Professor of Medicine, senior academic advisor, and a professor of preventive medicine in the Department of Population Health and Social Medicine, FAU Schmidt College of Medicine. “These drugs have beneficial effects on heart attacks, stroke, and kidney disease, another major consequence of untreated hypertension.”
Self-monitoring
“Health providers should counsel their patients to check their blood pressure each morning and night and whether to administer a particular drug or its dose, which should be adjusted accordingly based on the average of three readings taken about five minutes apart,” said Hennekens. “While uncontrolled hypertension remains alive and well in the U.S. and worldwide, strict attention to these issues by health providers has the potential to ‘kill the old silent killer.'”
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References/Sources/Materials provided by:
https://millionhearts.hhs.gov/data-reports/hypertension-prevalence.html
Metabolic Syndrome – What Is Metabolic Syndrome? | NHLBI, NIH
https://www.fau.edu/newsdesk/articles/old-silent-killer
http://dx.doi.org/10.1016/j.amjmed.2024.07.005
The Vicious Twins: Hypertension and Obesity In America – WorldHealth.net
