How to protect yourself from “the silent killer”: hypertension

Hypertension, or high blood pressure, affects one in eight adults aged between 20 to 40 worldwide,^[1] and one in three adults between ages 40 and 59. Dubbed “the silent killer,” hypertension may show no symptoms while silently causing organ damage throughout the body. While high blood pressure is typically associated with cardiovascular disease, it can also damage the brain, kidneys, eyes, and arterial blood vessels. It has also been shown to increase the risk of kidney cancer. 

Blood pressure is typically reported as your systolic over diastolic pressure, measured in millimeters of mercury (mm Hg).  Systolic pressure refers to the maximum pressure in the arteries when the heart contracts and pumps blood, while diastolic pressure is the minimum pressure in the arteries when the heart is at rest and filling with blood. Classifications of blood pressure according to the American Heart Association are listed below: 

There are numerous paths to managing hypertension, and you should discuss the best option with your doctor. 

One option is through medication. There are several classes of blood pressure medications,^[2] each with its own benefits and potential side effects: 

• Diuretics: Also called “water pills,” diuretics help the body get rid of excess salt and water. They are often used with other medications. 
• Beta-blockers: Beta-blockers work by lowering the heart rate, which can in turn lower blood pressure.
• Angiotensin-converting enzyme inhibitors (ACE inhibitors): ACE inhibitors help the body to produce less angiotensin, a chemical that causes arteries throughout the body to narrow. By reducing levels of angiotensin, ACE inhibitors allow the blood vessels to relax and open up.
• Angiotensin II receptor blockers (ARBs): While ACE inhibitors limit the production of angiotensin, ARBs block the effects of angiotensin.
• Calcium channel blockers: This medication helps to relax and open narrowed blood vessels by preventing calcium from entering the heart’s muscle cells and arteries. 
• Alpha blockers: Alpha blockers are a class of medications that work by blocking alpha-adrenergic receptors in the body, causing smooth muscles to relax, leading to widening of the blood vessels. 
• Alpha-2 receptor agonists: These medications block brain signals that can increase heart rate and constrict blood vessels. 
• Combined alpha and beta-blockers: These medications both alpha-adrenergic and beta-adrenergic receptors in the body. By doing so, they offer a broader range of therapeutic effects compared to medications that block only one type of receptor. These combined blockers are used to manage certain cardiovascular conditions where dual action is beneficial.
• Vasodilators: Vasodilators relax and widen blood vessels, and may be prescribed when high blood pressure is difficult to control with other medications. They may be used in hypertensive emergencies to quickly lower blood pressure and prevent organ damage. 

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For individuals who would prefer to avoid medication, there are also several ways to naturally reduce blood pressure:^[3]

• Weight loss: Weight loss is one of the most effective methods to manage blood pressure. In general, blood pressure will go down by about 1 mm Hg with each kilogram (2.2 pounds) of weight loss. Central obesity is particularly important. Carrying too much weight around the waist can increase the risk of high blood pressure.
• Exercise: Regular aerobic exercise can lower blood pressure by about 5 to 8 mm Hg. Strength training can also help lower blood pressure for some individuals. 
• Follow a nutrition plan: Dietary choices can help lower blood pressure by up to 11 mm Hg. The DASH diet (Dietary Approaches to Stop Hypertension) and Mediterranean diet have both been shown to reduce blood pressure. 
• Reduce salt intake: While the impact of sodium varies across individuals, reducing dietary sodium has been proven to reduce blood pressure. In general, it is recommended to limit sodium intake to 2,300 mg a day, but for most adults it is preferable to limit sodium intake to less than 1,500 mg per day. 
• Limit alcohol: Drinking too much alcohol can both increase blood pressure and make medications less effective. Stick to less than one drink a day for women, or two drinks a day for men. 
• Quit smoking: There are myriad health benefits to quitting smoking, and lower blood pressure is among them. 
• Improve your sleep: Getting less than 7 hours of sleep per night has a negative effect on blood pressure. Adults should aim for 7 to 9 hours of sleep per night.

All individuals with hypertension should measure their blood pressure and meet with their doctor regularly to make sure that medicines and lifestyle changes are working. While the “silent killer” may sound intimidating, there are numerous paths to get your blood pressure under control.

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