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Morning Checkup: High blood pressure and cardiovascular disease
INDIANAPOLIS (WISH) – Jacoby Jones, who played for the Baltimore Ravens, among other teams, scoring 3 touchdowns, including a 108-yard kickoff return touchdown in the 2013 Super Bowl (longest in Super Bowl history), died last month, just three days after turning 40 years old.
Jones was a man of faith, known for his charisma, jokes, dance moves, and willingness to help others. Unfortunately, his life was cut short. Autopsy results revealed hypertensive cardiovascular disease or heart disease from long-standing high blood pressure as the cause of death.
How do rates of hypertension and hypertensive heart disease compare amongst Americans?
- Black adults are hit hardest with 59% having high blood pressure.
- Black men are 70% more likely to have heart failure than white men.
- Black women are 50% more likely to have heart failure compared to white women.
- Black adults are 4x more likely to have end-stage renal disease, a complication of high blood pressure.
- Black women are 2x as likely to have high blood pressure in pregnancy, which may continue even after delivery.
- Four out of five Asian adults treated for high blood pressure are still uncontrolled.
What could be the cause of such health disparities?
Social determinants of health play a large role in the differences we see among various demographics, these may include access to quality education, healthcare, nutritious foods, and safe spaces for play and exercise. A child growing up in poverty in a food desert with no sidewalks and violence nearby, has an increased risk of disease, even into adulthood. Also, newer research is showing that racism and discrimination can also increase an individual’s risk of disease.
Additionally, Black patients are often initially prescribed a different class of medication than others, which was previously thought to be more beneficial. However, newer research is showing this may actually be counterproductive.
What is a target blood pressure goal?
For most adults, we recommend a blood pressure of 90-129/40-79. Blood pressure of 130-139/80-89 is considered stage I high blood pressure or pre-hypertension. High blood pressure is 140/90 and above.
What can be done if the doctor says you have pre-high blood pressure?
At this stage, we recommend lifestyle modifications:
- Initiate or increase physical activity to at least 150 minutes of moderate physical activity with at last 2 days of strength training. Partnering with a fitness trainer is advised. Some gyms offer at least an introductory session free of charge.
- Minimize salt consumption: watch packaged foods, canned foods, marinades and seasoning blends. I recommend no more than 1500 mg sodium for adults per day.
- Get restful sleep, at least 8 hours nightly for adults. If you snore, don’t wake up restful and/or fall asleep easily during the day, talk to your doctor about sleep apnea screening.
- Limit alcohol use: no more than 1-2 drinks daily or 4 in one setting. Recent research is cautioning that even this amount may be more harmful than previously thought.
- Avoid cigarettes and cocaine use.
- Improve stress management and treat any underlying mental health conditions.
- Seek out a doctor who you feel comfortable discussing concerns with and whose recommended treatment you are open to.
For Black Americans, studies show there is a benefit to seeking out a Black physician. Follow-up as recommended.
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