Uncontrolled Blood Pressure is Getting Worse

Don’t ignore hypertension. It makes COVID-19 more dangerous and puts you at risk for heart attacks and strokes. Here’s what you should know.

The number of Americans who don’t have their blood pressure under control is going up, according to new research.

High blood pressure, or hypertension, usually doesn’t create symptoms. It’s called the silent killer because you could feel fine — then one day have a heart attack or stroke. If you contract COVID-19 (coronavirus), high blood pressure could make your case serious.

It’s a common problem, affecting about 100 million Americans. That’s why the blood pressure cuff goes on during any ordinary doctor’s visit. Older men are routinely prescribed statin drugs to make sure their blood pressure stays healthy.

If you do have hypertension, diet, exercise, and a combination of medications can bring your measurements into safe ranges.

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Uncontrolled blood pressure is getting worse

In a study of more than 18,000 patients who had high blood pressure, scientists looked at multiple measurements over time. They found that blood pressure was controlled in 43.7 percent, down 10 points from 53.8 percent three years earlier. In other words, most patients didn’t keep their blood pressure in a safe range.

The researchers used cut-offs that may have underestimated the problem. They considered blood pressure controlled if the systolic measurement (the top number) was lower than 140 mm Hg and the diastolic measurement (the bottom number) below 90 mm Hg.

Under the most recent guidelines, your blood pressure isn’t actually normal unless it’s lower than 120 systolic and 80 diastolic. In between, your blood pressure could be elevated (120-129/less than 80) or in stage one of hypertension (130-139/80-89).

When the researchers analyzed the data using 130/80 as the dividing line, only 19 percent of the patients had their blood pressure under control.

Adults with hypertension older than 75 or under 44 were more likely to not have it under control. So were blacks and the uninsured.

The most important risk factor: not seeing your doctor in the last year. If you had, your chance of being in a safe range was five times greater.

Another issue is that too many patients receive only a single medication, when a combination may work better.

If you’re under 44, you might think COVID-19 isn’t a big problem for you, but high blood pressure could make your experience much worse.

Make sure you and your elders are taking medication as prescribed and have a doctor evaluating its effectiveness over time.

What you can do to manage blood pressure

• Lose extra pounds. Blood pressure often increases as your weight goes up, partly because you might end up with sleep apnea, a risk factor. You can cut 1 mm Hg for your blood pressure for about every 2 pounds you lose. The apple shape — big waistline and belly — is another risk factor. Men need to keep their waist at 40 inches or less, women at 35 or less.
• Exercise about 30 minutes most days — 150 minutes a week — and you can lower your blood pressure around 5 to 8 mm Hg.
• The DASH (Dietary Approaches to Stop Hypertension) diet, which focuses on whole grains, fruit and vegetables, and low-fat dairy, can cut blood pressure by up to 11 mm Hg. Cutting salt can cut 5 to 6 mm Hg. Cutting back on alcohol could cut about 4 mm Hg. (Also note that drinking alcohol interferes with hypertension medications).
• Quit smoking. Every cigarette raises your blood pressure as you smoke it.
• You can check if coffee affects your blood pressure, by measuring it before and 30 minutes after you drink your normal cup.
• Manage your stress — see friends and family, enjoy your stress-relievers, and be sure to get enough sleep.

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