There’s a reason your physician always checks your blood pressure when you visit. High blood pressure affects 1 out or 3 adults over the age of 20. Elevated blood pressure is a major risk factor for cardiovascular disease, stroke, and dementia. Plus, hypertension damages organs in the human body, including the kidneys. The more you know about your health and about your health risks, the more you can do to protect yourself. Here are 6 common myths about blood pressure debunked!
Myth: The Upper Number is More Important Than the Lower Number
Systolic blood pressure (the upper number) is a measure of the force in the walls of your arteries when your heart contracts. The diastolic pressure (the lower number) is the pressure when the artery relaxes between heartbeats. Blood pressure is expressed as the systolic reading over the diastolic reading.
At one time, health care providers placed more emphasis on controlling diastolic blood pressure, the lower number, and were less concerned about the systolic pressure. These days, the focus is again on the systolic blood pressure, but both numbers matter. Elevation in either number can be used to make the diagnosis of hypertension. According to the American Heart Association, the risk of stroke and ischemic heart disease rises two-fold with every 10 mm Hg increase in diastolic blood pressure. It also doubles with every 20 mm Hg increase in systolic blood pressure in middle-aged and older people. Both numbers matter!
Myth: If Your Blood Pressure is Normal at Your Doctor’s Office, You Don’t Need to Worry
There’s a phenomenon called masked hypertension. This is a condition where blood pressure is normal when you’re at your doctor’s office but too high when you’re out and about or at home. It’s the opposite of white coat hypertension where blood pressure is higher in a clinic or doctor’s office and normal at home.
It’s not clear how many people suffer from masked hypertension, but estimates are that it affects as many as 1 out of 10 adults. Like established high blood pressure, masked hypertension carries a higher risk of mortality and damage to organs in the body. That’s why you should check your blood pressure at home regularly, even if your doctor checks it at on your scheduled visits. Keep a record of the readings and show them to your health care provider.
Myth: Hypertension is Mostly a Health Problem in Older Adults
Blood pressure goes up with age, but high blood pressure is being diagnosed at younger and younger ages, partially due to rising rates of obesity. A study that monitored blood pressure readings of 14,000 women and men ages 24 to 32 found that 19% had elevated blood pressure. The earlier it appears and goes untreated, the earlier you can develop damage to organs, like the kidneys, brain, and heart.
Myth: You Only Have to Measure Blood Pressure in One Arm
If you have a 15 point or more difference in blood pressure between your two arms, it could signal a greater risk of peripheral artery disease, obstruction in the blood vessels in your arms or legs. In a British study, men and women with this much blood pressure variation between arms had twice the risk of developing peripheral artery disease as well as an increased risk of stroke and cardiovascular disease. When you check your blood pressure, check it in both arms.
Myth: You Can’t Prevent Hypertension
Many people still have the idea that if they’re genetically predisposed to hypertension, they’ll get it. 90% of hypertension is called essential hypertension. This means there is no identifiable cause. Most cases of essential hypertension have a genetic component. The other 10% is secondary hypertension. This type of hypertension has an underlying cause. The most common cause is a narrowing of an artery that leads to the kidney called the renal artery. In some cases, doctors may place a stent to open up the narrow artery or do a procedure to bypass it. But in mild cases, blood pressure medications may control it. Certain endocrine problems can also cause secondary hypertension. If you have blood pressure that’s poorly controlled on several medications, it suggests that there may be a secondary cause.
You can even prevent essential hypertension or delay its onset. Here’s what you can do:
· Lose weight if you’re overweight or obese
· Exercise at least 150 minutes per week at a moderate intensity
· Eat a healthy, whole food diet. The DASH diet is linked with a lower risk.
· Don’t smoke
· Reduce or eliminate alcohol
· Manage stress
Myth: It Doesn’t Matter When You Check Your Blood Pressure
Ideally, check your blood pressure in the morning and the evening. If your evening blood pressures is 20% lower than your morning ones, you may have morning surge hypertension, a significant rise in blood pressure when you wake up. Morning surge hypertension is independently associated with a higher risk of heart attack, heart failure, and stroke. People who are obese or have type 2 diabetes are at higher risk. Women and older people are too.
To monitor for morning surge hypertension, check your blood pressure about an hour after you wake up and before going to bed. Avoiding eating or consuming caffeine before measuring your blood pressure. Record the values and show your physician.
The Bottom Line
It’s not hard to measure your blood pressure at home and there are many benefits to doing so. If you take it at home, check it twice a day to make sure you don’t have morning surge hypertension. You can also get readings to show your physician. If you have big differences in blood pressure between home and the doctor’s office, your health care provider should know. Hypertension is a major risk factor for cardiovascular disease and stroke. It’s also associated with a higher risk of dementia. So, monitor your blood pressure closely and take the numbers seriously. It could be lifesaving.
References:
Hypertension Research volume 30, pages 479–488 (2007)
NIH MedLine Plus. “More Young Adults at Risk for High Blood Pressure”
MDEdge.com. “Young adults with hypertension may be at higher CVD risk”
Harvard Health Publishing. “Different blood pressure in right and left arms could signal trouble”
Pharmacy Times. “What’s Up with Morning Blood Pressure?”
MedLinePlus.gov. “High Blood Pressure”
Centers for Disease Control and Prevention. “High Blood Pressure”
WebMD. “High Blood Pressure: The First Number vs. The Second Number”
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