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AARP Bulletin

High Blood Pressure Is the Silent Killer

Millions of Americans have hypertension, but many don't even know they have it

Nearly 20 percent of adult Americans are living with hypertension — commonly known as high blood pressure — and don't know it, according to the latest estimates from the American Heart Association.

Only about half of the 78 million Americans diagnosed with hypertension are controlling it. And yet, uncontrolled high blood pressure is a major risk factor for devastating health problems — including stroke, heart attack, heart failure and kidney disease.

See also: Herbs and spices to help you shake the salt habit

Hypertension is dangerous "because it's so often ignored," says Nieca Goldberg, M.D., medical director of the Joan H. Tisch Center for Women's Health at NYU Langone Medical Center.

A New Look at High Blood Pressure

Keep your blood pressure in check to reduce your chances of having a heart attack. — Sam Kaplan

To protect your health, it's important to have your blood pressure checked by a professional — at least once a year. A blood pressure check measures the force of blood pushing against the artery walls as the heart pumps blood.

This pressure normally rises and falls throughout the day, but when it stays high over time, it's called high blood pressure — a chronic medical condition that damages arteries and requires the heart to work harder than normal to circulate blood to the organs.

Fortunately, there are steps you can take to prevent and control it. Here are 11 key questions and answers with the latest information on hypertension.

1. What are the symptoms of hypertension?

There usually are none, which is why it's been dubbed the silent killer. But if your blood pressure climbs to extreme highs, you might experience a severe headache, chest pain, shortness of breath, vision changes or a nosebleed, says George Thomas, M.D., of the Cleveland Clinic.

2. Am I at risk for high blood pressure?

Men and women are equally at risk over their lifetimes, but it is more common in African American adults than in Caucasian or Hispanic American adults, according to the National Heart, Lung, and Blood Institute. It's usually impossible to pinpoint an exact cause of high blood pressure. But it has been linked to a number of factors: Your risk increases if you have a family history of hypertension. And unhealthy lifestyle habits also can increase your risk — including smoking, too much salt in your diet, too much alcohol, lack of exercise, excessive weight and chronic stress.

3. Why is blood pressure measured in two numbers? Are they equally important?

Blood pressure readings have an upper and lower number, such as 120/80. The higher "systolic" number measures artery pressure when the heart beats, pumping blood to the organs. The lower, or "diastolic," number measures the pressure of blood in the arteries between beats, when the heart relaxes. For people 50 and older, the top number is more significant, according to the American Heart Association. Systolic blood pressure rises steadily with age because of changes in blood vessels.

4. What are "good" blood pressure numbers?

Lower than 120/80 is considered a normal, healthy reading. Higher numbers — up to 139/89 — suggest prehypertension, when you need to start making lifestyle changes to head off full-blown hypertension. A reading of 140/90 signals hypertension, which could progress to 160/100 or higher.

5. Can I avoid or control high blood pressure with lifestyle changes?

Researchers all agree that you can help control blood pressure if you reduce your salt intake, eat plenty of fruits and vegetables, exercise and maintain a healthy weight.

Studies have shown that blood pressure numbers can drop by five points with a weight loss of just 5 to 10 percent.

Reducing salt intake also can lower your blood pressure, says Samuel J. Mann, M.D., of New York-Presbyterian Hospital/Weill Cornell Medical Center. But in a controversial May report, the Institute of Medicine suggested that cutting salt to 1,500 milligrams daily — the current recommendation for those with hypertension — may actually increase health problems. It concluded there's no reason to reduce sodium intake to less than 2,300 mg daily (about a teaspoon of salt), the general level the government recommends for most Americans. Talk to your doctor about your salt consumption.

Next page: Is there a diet for hypertension? »

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PREVENT HIGH BLOOD PRESSURE: Learn more about the risks, causes and how you can avoid getting hypertension. So many people are not aware they have it; that's why it's known as a "silent killer."

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