Hypertension causes of death are on the rise according to the American Heart Association (AHA). Hypertension (AKA high blood pressure) is the number one contributor to disease and health care cost globally. Fewer people are dying from heart disease and stroke, today. Heart disease is still the largest killer in the U.S., however, deaths decreased by 33% from 2001 to 2011. Prevention methods and improved treatments are credited with the reduction.
The continued decline in deaths attributable to cardiovascular diseases is encouraging to many doctors. By implementing evidence-based prevention and treatment guidelines, the healthcare industry hopes to continue to push the numbers downward. Concerns are growing, however, over a 13% increase in hypertension-related deaths over that same 10 year span.
High blood pressure is a major risk factor for heart disease and stroke. Even though, the mortality rates for heart disease and hypertension are trending in the opposite direction. One reason for the seeming contradiction is hypertension can contribute to coronary heart failure and kidney disease alike.
What does the blood pressure number mean? The first number, called systolic blood pressure, measures the pressure in your blood vessels when your heart beats. The second number, called diastolic blood pressure, measures the pressure in your blood vessels when your heart rests between beat.
AHA recommends treatment if blood pressure is 140/90 or higher and research shows that lowering blood pressure by just 5 points reduces the overall risk of death from all causes by 7%. Eighty-three percent of all high blood pressure cases have been detected. However, of the 80 million Americans with high blood pressure, only about half have it under control.
The exact causes of high blood pressure are not known, but several factors and conditions may play a role in its development. Rising hypertension death rate related to factors plaguing many Americans lack of physical activity, obesity, smoking and too much sodium. It is clear that overweight and obesity increases the risk for high blood pressure.
Other Medical Causes of High Blood Pressure:
- Overweight or Obese
- Lack of Physical Activity
- Chronic Kidney Disease
- Sleep Apnea
- Thyroid problems
High blood pressure tends to run in families and is more likely to affect men than women. Age and race also play a role. In the United States, blacks are twice as likely as whites to have high blood pressure, although the gap begins to narrow around age 44. After age 65, black women have the highest incidence of high blood pressure.
Body Fat Linked to Hypertension
Research suggests that visceral fat is more harmful than subcutaneous fat, linking deep belly fat to serious health problems like heart disease and diabetes. Researchers performed imaging tests on a diverse group of adults to assess two types of belly fat subcutaneous and visceral. Subcutaneous fat is the fat that lies directly under the skin, while visceral fat lies deep within the abdomen surrounding the body’s organs.
Deep belly fat increased the risk for high blood pressure by 22%, while superficial belly fat did not increase blood pressure. Being overweight and obesity increased the risk for hypertension by 24%.
Hypotension or Low Blood Pressure
Low blood pressure characterized by an inadequate flow of blood to the body’s organs can cause strokes, heart attacks and kidney failure. Hypotension is the medical term for low blood pressure (less than 90/60). A change of just 20 mm Hg, a drop from 110 systolic to 90 mm Hg systolic, for example, can cause dizziness and fainting when the brain fails to receive an adequate supply of blood. Current guidelines identify normal blood pressure as lower than 120/80 mm Hg.
Throughout the day, blood pressure varies, depending on body position, breathing rhythm, stress level, physical condition, medications you take, what you eat and drink and time of day. Blood pressure is usually lowest at night and rises sharply on waking. These symptoms are most prominent when individuals go from the lying or sitting position to the standing position (orthostatic hypotension).
Heart Rate and Cardiovascular Disease
Elevated heart rate is a risk factor for cardiovascular disease is supported by numerous epidemiologic association studies. Heart rate predicts mortality and morbidity in a variety of cardiovascular diseases, independent of other factors. Research suggests a relationship between heart rate and cognitive decline and poor functional outcome in patients with acute ischemic stroke.
For 60 years, an association between heart rate and cardiovascular disease became apparent. However, translating research into clinical practice has been a challenge for the clinician. Clinicians should measure heart rate together with blood pressure and they should appreciate that the occurrence of high heart rate may portend the presence of other cardiovascular risk factors.
There is an association between the levels of resting heart rate and coronary mortality. We can estimate that an increase in heart rate by 10 beats per minutes is associated with an increase in the risk of cardiac death by 20%; increase in resting heart rate by 5 bpm was associated with a 17% increase in 10 year cardiovascular mortality.
Heart Rate and Blood Pressure
Borderline or sustained hypertension either is related to a slight yet significant increase in heart rate. Heart rate and blood pressure were significant even after taking into account several confounding factors such as body mass index, age and metabolic parameters; found in different age groups and both sexes. There is a strong association between high blood pressure and heart rate.
The increase in cardiovascular disease risk in subjects with increased heart rate could be even more important (predictive especially in men) in hypertensive than in normotensive subjects. Hypertensive men, heart rate and blood pressure, might act synergistically in the development of cardiovascular complications.
Hypertension and Treatment
Heart rate is an independent risk factor for cardiovascular morbidity and mortality. Currently, the primary treatment method is pharmacological. Drug therapy is the most prescribed form of treatment and the primary method described with addressing the issue. Preventive methods of treatment receive little or no mention as a possible treatment.
American’s attitude toward prevention is increasing; Millennials are more likely to practice preventative methods than their predecessors. Baby Boomers could best describe themselves as the drugs first generation. The pharmaceutical industry has drastically improved the lives of all American’s over the past few decades. However, with every improvement come side effects. It is not uncommon to have a family member who is taking a pill to lower their blood pressure and another pill to offset the side effects of that pill.
If we know that an increase in heart rate increases cardiovascular deaths by X%, then reason says lowering heart rate by X would decrease cardiovascular deaths. There is also a positive association between heart rate and blood pressure. Physical activity reduces both heart rate and blood pressure. What is not known is the specific amount of activity required or the pace of the activity to receive benefits.
Research has failed to discover appropriate preventative methods. The Journal of American Medical Association published these findings in 2016. The problem is a lack of funding. Biomedical funding is huge due to the potential for huge rewards. Biomedical science has produced incredible results albeit at the expense of everything else. The saying goes; there is plenty of funds for treatment and zero for prevention.
As we age, the treatment for heart rate and blood pressure should be a mixture of both pharmaceuticals and activity. For most people, physical activity alone could be sufficient if consistently employed. The challenge is documenting clinically plausible treatments utilizing an evidence-based mixture of drugs and activity. The science is pending. I fear we may be waiting for a while. #hypertension #heartrate #healthcare #healthoutcomes