Baton Rouge Clinic Health Library

Cardiovascular Health > Hypertension: Confronting the Silent Killer

     Published: 07, 2005

Nearly 1 of every 4 adults in the United States has hypertension. That is approximately 50 million Americans! Unfortunately, the most recent data suggests that while 70% are aware of their diagnosis and nearly 60% are receiving treatment, only 34% are actually treated to the currently accepted goals.

There is a clear relationship between high blood pressure and stroke, heart attack, heart failure, and kidney failure. Small improvements in blood pressure translate into substantial health benefits. For example, just a 2 point drop in blood pressure is associated with a 7% reduction in death from heart disease and a 10% reduction in stroke death. Taken together, this data suggests there is a significant opportunity for improving the health of our community by increasing screening efforts, educating patients on the importance of diagnosis and treatment, and facilitating effective physician-patient interactions that allow more patients to reach their treatment targets.

Hypertension is defined as repeated blood pressure measurements of greater than 140/90. A large proportion of Americans have “prehypertension,” defined as blood pressure between 120-140/80-90. These patients are at high risk for developing high blood pressure and should be counseled on aggressive lifestyle improvement efforts. Optimal blood pressure, regardless of age, is less than 120/80. High blood pressure is frequently called the “silent killer” because of its lack of symptoms. Most people do no “feel” high blood pressure, but a simple measurement can be life-saving!

The vast majority of patients with high blood pressure have a genetically-determined type of high blood pressure called “essential hypertension.” The remainder have high blood pressure caused by a variety of relatively uncommon conditions. In this case it is referred to as “secondary hypertension.” The causes of secondary hypertension include thyroid and other endocrine disorders, sleep apnea, blockages of the arteries leading to the kidney, tumors of the adrenal gland, and certain kidney diseases.

Treatment for the majority of patients with hypertension starts with weight reduction, regular aerobic exercise, salt restriction, smoking cessation, and moderation of alcohol. Alcohol in excess (defined as greater than 1 drink per day in women, 2 in men) is perhaps the most common environmental factor affecting blood pressure in our community. Dietary interventions can be very effective at lowering blood pressure. Perhaps the most studied of these is the DASH diet. Information regarding this diet can be downloaded from the NIH website: www.nhlbi.nih.gov.

When lifestyle interventions fail to lower blood pressure to goal, a variety of well-proven drugs are available. It is important to note that the average patient with high blood pressure will require approximately 3 drugs to reach the treatment goal. For patients with diabetes or chronic kidney disease, that goal is 130/80 or less. All other patients have a goal of 140/ 90 or less. While many hypertensive drugs do have side effects, in most cases these are not serious and can be managed. In all cases, not treating high blood pressure can have disastrous results.

It is important to recognize that the prevalence of hypertension increases with age. A 50 year-old with normal blood pressure still has a 70-80% chance of developing high blood pressure in his/her lifetime! As such, we must all be vigilant in monitoring blood pressure, maintaining healthy lifestyles, and seeking appropriate treatment as soon as high blood pressure is recognized.

Dr. Carmouche is certified as a Specialist in Clinical Hypertension by ASH, the American Society of Hypertension. He is the director of the Center for Cardiovascular Disease Prevention at the Baton Rouge Clinic and is available for consultation regarding unusual or difficult cases of hypertension. Please call 246-9240 to schedule an appointment today.

David G. Carmouche, MD
Specializing in The Cardiovascular Center of Excellence

The Baton Rouge Clinic, AMC, offers this information as a courtesy service. Please remember that medical knowledge is always evolving and we cannot represent that any of our information is absolutely current. Please consult a physician before taking any medical action based on information gathered from this or any website.