University of Iowa Health Science Relations and
Theresa Brennan, MD
Assistant Professor of Internal Medicine
First Published: 2004
Last Revised: September 2004
Peer Review Status: Internally Peer Reviewed

From a health column by UI Hospitals and Clinics cardiologist Theresa Brennan, MD, first published by the Iowa City Press-Citizen.

The recent news about hypertension is not good.

New figures from the federal government show that the number of adults in the United States with high blood pressure increased by nearly a third during the last 10 years. Sixty-five million Americans--one out every three of us--now have hypertension, compared with 50 million a decade ago.

The fact that the U.S. population is larger and older than it was 10 years ago only partially explains the increase.

The percentage of overweight and obese Americans is also a major contributing factor. Over the past 40 years, heart attack and stroke rates went down, but now that blood pressure levels are going up, heart attack and stroke rates also will likely increase.

High blood pressure is defined for most people as having a systolic (top) number of 140 mm Hg or higher and/or a diastolic (bottom) number of 90 mm Hg or higher.

People who are age 45 or older, non-Hispanic black females, non-Hispanic white males, or Mexican Americans are the most likely to have hypertension. They also are likely to not know they have the disorder, and only about one-third of them have been able to adequately control the condition with medication.

In addition, an estimated 50 million Americans now have a newly recognized condition called pre-hypertension. People in this new category have blood pressures of 120 to 139 millimeters of mercury systolic (top number) or 80 to 90 diastolic (bottom number), according to the National Heart, Lung, and Blood Institute. They are considered to have a two-fold higher risk of developing "full" hypertension.

It is clear that we have to enhance our efforts to make people more aware that high blood pressure continues to be a major public health threat. Fortunately, we have other successful models that have helped people better understand hazards to their health, such as smoking and consumption of high levels of fat in the diet.

As with all disease, prevention is the most effective way to deal with a disorder.

We need to stress that calories do count and that maintaining a healthy weight is important.

People need to eat right and move more.

Most of us will benefit from trying to reduce salt intake.

We also have to encourage people to get their blood pressure checked and to get treatment, if needed.

Hypertension often is called "the silent killer" because people frequently don't have any symptoms, which can allow the damage to progress until a major event such as a heart attack or stroke occurs.

Diagnosing hypertension early is as easy as seeing your doctor, and appropriate treatment can prevent many of the complications of the condition.