There has been an increased focus on heart disease awareness and prevention for women within the medical community of late. While it remains the number one killer of both sexes, recent data shows that a male’s risk of dying from heart disease has declined over the past few decades, yet the same is not true for females.
Hypertension, also known as high blood pressure, continues to be one of the leading causes of heart disease in our country. There’s a misconception that hypertension is more common in men. The statistics are actually fairly even, with 1 in 3 of all U.S. adults having high blood pressure. Young men tend to have high blood pressure more frequently than young women, but starting at age 55 a woman’s likelihood of having high blood pressure actually rises more sharply.
When I talk to patients about hypertension, I remind them that the heart is a pump pushing blood through our arteries much like water is pushed through a garden hose. It is normal for someone’s blood pressure to increase when they are physically active or experiencing stress. If the pressure is too great for too long a period of time, however, it can damage the arteries, the heart, or other parts of the body. In addition to chronic conditions like heart disease and stroke, untreated high blood pressure can also lead to vision loss, kidney damage and peripheral artery disease, among other conditions.
Checking blood pressure might be the most fundamental of all the tests we do during a person’s routine wellness exam, male or female. It is also one of the most critical since there are generally no outward symptoms of hypertension. The readings we take measure the pressure in the arteries when the heart beats (systolic) and in between beats (diastolic). When a nurse or clinician says your blood pressure is “120 over 80,” the first number is the systolic pressure and the second is the diastolic, and those figures are considered normal blood pressure for a healthy adult.
If either number rises above that 120 over 80 baseline, we would want to re-test your blood pressure at a separate appointment to be sure the reading is accurate. There are a number of factors that may cause a high reading, including eating foods high in sodium or experiencing temporary stress shortly before an appointment. Some people even experience “white coat hypertension,” meaning the very act of having a wellness exam causes their blood pressure to go up. But if the reading is consistently high over a period of two or three visits, we could make a diagnosis of prehypertension or hypertension with confidence and plan a course of treatment.
Nearly every case of hypertension is what we call primary hypertension. While we don’t know exactly what causes this type, a number of contributing factors include age, diet, tobacco use and physical activity. About 5 to 10 percent of all hypertension cases are secondary, meaning they are related to kidney disease or some other endocrine disorder. Both can be treated through a combination of prescription medications and modifications to a person’s lifestyle.
I am a big proponent of lifestyle modification as a first step for treating hypertension. You can bring your blood pressure down to normal just as quickly by adopting some better eating and exercise habits as you can with a drug. Working with patients to adopt these lifestyle modifications is easier now with Vermont’s Blueprint for Health. Through this initiative, our patients have access to services provided by the BMH Community Health Team. This might include getting help quitting smoking or meeting with a nutritionist to learn about low-sodium diets. They can even help people better manage their medications if that’s necessary.
Services provided by the Community Health Team are free to patients of Brattleboro Internal Medicine, as well as many other primary care practices in the community. It’s a great opportunity to get information and help managing your hypertension. The first step is scheduling a wellness visit with your health practitioner. Men should do it to keep their chances of heart disease on the decline, women should do it to avoid having this “silent killer” make them another statistic.
Roxanne Karter, APRN is a board certified adult nurse practitioner at Brattleboro Internal Medicine, a department of Brattleboro Memorial Hospital.