Undiagnosed and untreated - what's your blood pressure?

Last week, the focus was global hypertension problems. Now, in a North American study, we learn that high blood pressure is often undiagnosed, untreated:

For the study, the researchers measured the blood pressure of almost 1,100 volunteers. The measurements were taken at mobile clinics that the researchers had set up at shopping malls, workplaces, hospitals and community centers in a large city.

The study revealed that 50 percent of the participants were unaware they had high blood pressure. Of these people, 2 percent were at very high risk for health complications.

The findings were published online Jan. 5 in the American Journal of Hypertension.

"What is particularly significant about this study is that a surprisingly large number of participants exhibited some type of hypertensive urgency or emergency," study author Dr. Grant Pierce said in a journal news release. Pierce is executive director of research at St. Boniface Hospital in Winnipeg.

Most of the people with high blood pressure weren't being treated even if they had been diagnosed. The study authors suggested that either these people didn't fully understand their condition, or they didn't understand the health consequences associated with high blood pressure.

High blood pressure is the leading cause of strokes. Taking it seriously might save a life.

The world is experiencing a high blood pressure increase

High blood pressure - hypertension - is the leading risk factor for strokes.

So the news is a little frightening - high blood pressure is increasing worldwide:

"There are almost 900 million people in the world with hypertension, and there are almost 3.5 billion people with elevated blood pressure that doesn't quite meet the definition of hypertension," said study lead author Christopher Murray. He directs the University of Washington's Institute for Health Metrics and Evaluation in Seattle.

"Blood pressure is the leading cause of premature death and disability in the world," Murray said.

Blood pressure is made up of two numbers. The top number, called systolic pressure, measures the pressure in the arteries when blood is being pumped from the heart. The bottom number, the diastolic pressure, measures pressure between heartbeats. Blood pressure is expressed in millimeters of mercury (mm Hg).

The study authors said that even systolic blood pressure within what is considered a normal range -- less than 120/80 mm Hg, according to the American Heart Association -- can increase the risk of heart attack and stroke.

It's important to pay attention to your blood pressure and if needed, work with your health professionals to control it.

(Photo from U.S. Centers for Disease Control and Prevention)

Stroke risk factors that need a solution

If you've read much of this blog, you've seen items about smoking, diet and other stroke risk factors. Click here to read a compilation.

But are you always in complete control of those risk factors? Or does just living in a poor neighborhood up stroke risk?:

Women and men of all races in the poorest neighborhoods were more likely to suffer a stroke than those in the richer neighborhoods. This held true even after the researchers adjusted for other factors such as age, race, sex and region of the country.

From a stroke survivor - take high blood pressure seriously

High blood pressure is the leading cause of strokes. So it should be taken very seriously. A stroke prevented is one life possibly saved or one person potentially not disabled. As a stroke survivor, I wouldn't wish a stroke on anyone.

So we need to better than this -  1 in 4 Medicare patients uses blood Pressure meds incorrectly:

An analysis of 18.5 million Medicare Part D enrollees in 2014 found that 26 percent either skipped doses of their blood pressure medication or stopped taking the drugs entirely, according to the study from the U.S. Centers for Disease Control and Prevention.

The lifestyle battle: Key for stroke survivors

Never thought about post-stroke life like this idea - unlike, say, cancer, you're never "cured" exactly. Rather, every day without another stroke is a win.

Read this interesting take how pre-stroke lifestyle tied to long term risk of more strokes, dementia:

Unlike a condition such as cancer, where if you undergo treatment successfully and survive ten years we might say “you battled it, you’re cured,” increased health risks remain after a stroke, Ikram said. This shouldn’t be discouraging, but should encourage people before or after stroke to do what they can to prevent another, he said.

“Once you suffer a stroke, treatment shifts toward medication and simple preventive measures are pushed to the background,” Ikram said. “Don’t neglect the simple things like quitting smoking, exercising more and controlling blood pressure.”

I won't argue with the idea of quitting smoking, which is one of the deadliest thing a human can do,  or with controlling blood pressure, the leading cause of strokes.

If we can prevent just one ...

I know stroke survivors who didn't have preventable strokes but due to hidden causes.

But if you're a stroke survivor or care about someone who is a stroke survivor, then you might care about stroke risk factors and how much of a role they plan in nine out of 10 strokes.

A recent study indicated that stroke is largely preventable:

Hypertension (high blood pressure) remains the single most important modifiable risk factor for stroke, and the impact of hypertension and nine other risk factors together account for 90% of all strokes, according to an analysis of nearly 27000 people from every continent in the world (INTERSTROKE), published in The Lancet.

'Mind your risks' especially important for high-risk populations

The best way to "treat" a stroke is to prevent it. This is from someone who had one.

Of course, not every stroke is preventable. Mine was a cryptogenic stroke. But the great majority are preventable, and here's an item about efforts in the area of racial disparities in stroke:

"The prevalence of hypertension is higher in blacks, but its impact is even greater in the black population. An increase of 10mmHg in blood pressure is associated with an 8 percent increase in stroke risk among whites but a 24 percent increase in stroke risk in blacks," said Dr. Walter Koroshetz, director of NINDS.

Getting serious about salt? We consume more than you might think

We've heard it before: too much salt in American diets. And since salt is a contributor to high blood pressure - the leading cause of strokes - too much can be serious.

Now, the FDA has issued new guidelines to target the sodium hiding in our diets:

Too much salt can raise blood pressure and increase the risk of heart disease and stroke, as many research studies have demonstrated. "Experts at the Institute of Medicine have concluded that reducing sodium intake to 2,300 mg per day can significantly help Americans reduce their blood pressure and ultimately prevent hundreds of thousands of premature illnesses and deaths," Susan Mayne, director of the FDA's Center for Food Safety and Applied Nutrition, said in a statement.

Blood pressure - finding patterns might help prevent strokes later

High blood pressure, as we know, is the leading cause of strokes.

Now, it seems, reviewing patterns in a person's blood pressure over time - in years - might find clues about predicting stroke risk:

For this new study, Portegies and her colleagues collected 20 years of data on the systolic blood pressure (the top number in a blood pressure reading) of more than 6,700 Dutch adults. Participants were ages 55 to 106 and living in a suburb of Rotterdam.

Common sense department: Eat your vegetables, take your meds

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licensed by CC BY 3.0)

As your mother said: Eat your vegetables.

Now, here's another, from health professionals: Take your medicine.

Check out this recent research about how not taking preventive meds is linked to fatal strokes:

Patients noncompliant with their antihypertensive and statin therapies had 7.43-fold ... increased risk of stroke death compared with people adherent to both, Kimmo Herttua, PhD, of the University of Southern Denmark in Esbjerg, and colleagues reported online in the Journal of the American College of Cardiology.

Taking one of the two medications but not the other lowered their risk of fatal stroke but didn't eliminate it compared with taking both, said the investigators.

Managing blood pressure - lowering those numbers

Photo from
http://www.medisave.co.uk via Flickr

Pay attention, keep track and act when needed - key elements to control high blood pressure, the leading cause of strokes.

Read a recent study illustrating this importance and how intensive blood pressure management is feasible in post-stroke care:

"Active management of systolic blood pressure in this population using a 140 mm Hg target led to a clinically important reduction in blood pressure," they wrote, adding, "Active management of blood pressure after stroke/transient ischaemic attack is more important than the target that is set."

"The additional resources needed to achieve the additional 3 mm Hg lower blood pressure in the intensive target arm might be better spent in increasing the proportion of people with stroke in primary care who have a systolic blood pressure below 140 mm Hg."

Their Prevention After Stroke -- Blood Pressure (PAST-BP) study included 529 patients at 99 general practices in England who were randomized open-label to treatment to an intensive target of under 130 mm Hg (or a 10 mm Hg reduction from baseline if they started below 140 mm Hg) or a standard target of less than 140 mm Hg.

"Apart from the different target, patients in both arms were actively managed in the same way with regular reviews by the primary care team," Mant's group noted."

The reduction of blood pressure readings might have been small, but which level would you rather have?

What are your blood pressure numbers? And what number seems like a good idea?

Still more about the quest for blood pressure target numbers- this time, how that the gray area for high blood pressure can make risky targets of women and minorities:

Stroke risk is lower for healthy older adults with blood pressure under 140 mm Hg than in the disputed 140 to 149 mm Hg range, particularly for minorities and women, according to a cohort study.

In the prospective population-based Northern Manhattan Study cohort of 1,750 people 60 and older, and free of stroke, diabetes, and chronic kidney disease (CKD) at baseline, the adjusted odds of incident stroke over a median 13 years of annual follow-up were a significant 70% higher with a systolic blood pressure of 140 to 149 mm Hg than with lower blood pressures.

Good advice - find the balance between treatment risks and benefits

Photo from U.S. Centers for Disease Control and Prevention

Now, as Paul Harvey used to say, the rest of the story.

I've posted quite a bit about high blood pressure as a stroke risk. It's the leading cause of strokes.

A wise doctor, as part of taking care of my aging mother a few years ago, described health decisions about her as a balancing act. Take this medication, and it might affect that ailment, which might affect other medication, and so on and so on. Truer words were never spoken.

Now, here's some thoughts to consider about high blood pressure, new targets and possible medication side affects, in an article stating that new blood pressure guidelines a danger to patients:

Why watch the salt? Read the latest facts

How much salt do you need? Probably less than you consume.

If you are a typical American consumer, chances are 9 out of 10 that you consume too much sodium. The problem? It can contribute to high blood pressure, which is the leading cause of strokes.

This has been in the news before, of course, but habits are hard to break. Read more how Americans still consume too much salt:

More than 90 percent of children and 89 percent of adults consume more sodium than is recommended in the new 2015-2020 Dietary Guidelines for Americans, according to the U.S. Centers for Disease Control and Prevention. The new guidelines advise no more than 2,300 milligrams (mg) of salt a day -- about a teaspoon -- for most adults.

How you or someone you care about can prevent a stroke

Photo from meddygarnet via Flickr

High blood pressure - as you likely know - is the leading cause of strokes. Once this becomes controlled, stroke risks get reduced.

How? One helpful tip is an obvious one: Take your medicine as prescribed.

Does someone you care about have a unpleasant side effect? That's entirely possible. But before abandoning hope, encourage that person to talk to a doctor. More and more research shows blood pressure control's importance - even if it's not super-high. Check out this recent story about high-risk patients should get blood pressure meds:

Preventable strokes and treatment - finding answers, saving lives

Photo from Pete via Flickr

I'm sold on stroke prevention. It saves lives and it gives society more resources to battle health problems.

An interesting research take about 'preventable' strokes and treatment:

Three out of four strokes could be avoided, and one in four are "highly avoidable," according to a study assessing stroke preventability. It also found that strokes considered the most treatable were the most preventable.

Those were the findings when a 10-point stroke preventability scale -- incorporating key measures such as treatment for hypertension, high cholesterol, and atrial fibrillation -- was applied to 274 consecutive ischemic stroke patients treated at a single institution. ...

Feel like you're on a high wire for your health?

Photo by Morgan via Flickr

During a discussion of the health care of my mother in the last few years of her life, a smart doctor told us that as someone ages, much of health care becomes a balancing act.

Or maybe it's not just about aging, but blood pressure in any age. Check out recent research about how blood pressure control can cut stroke risk but might result in trade-offs

And the rate of all cardiovascular events, including heart attack, stroke, and cardiovascular death, was 25 percent lower in the group that received aggressive treatment: 243 events in those 4,678 patients, compared with 319 events in the 4,683 that got less medicine.

This must be a high priority item - to save lives

Photo from Doug McCaughan via Flickr

Chances are, you have high blood pressure or you know someone with high blood pressure.

Chances are, you know that high blood pressure is the leading cause of strokes.

Now, it's even clearer that even tighter control of high blood pressure is a key to stroke prevention:

"Our results provide important evidence that treating blood pressure to a lower goal in older or high-risk patients can be beneficial and yield better health results overall," said Dr. Lawrence Fine, chief of the Clinical Applications and Prevention Branch at the U.S. National Heart, Lung, and Blood Institute. "But patients should talk to their doctor to determine whether this lower goal is best for their individual care."

Stroke prevention: Not glamorous, but more effective than all the high-tech tools we have

This week's postings are devoted to stroke prevention. It's not glamorous or exciting. Very little cutting-edge research using whiz-bang technology.

Instead, it's about high blood pressure, diet, smoking, diabetes and the like.

But controlling those factors could prevent more strokes, keep fewer people disabled and prevent more strokes than any high-tech solution - at least during my lifetime.

So, pass along a recent CDC write-up about American Stroke Month and National High Blood Pressure Education Month:

Stroke is largely preventable. You may be able to prevent stroke or reduce your risk through healthy lifestyle changes. High blood pressure is one of the major risk factors for stroke. Others include high cholesterol, smoking, diabetes, heart disease, obesity, physical inactivity, and unhealthy diet.

Treating even mild high blood pressure can pay off

I'm a big believer in watching blood pressure - it can be a sign of many, treatable problems. That includes stroke. In fact, high blood pressure is a leading cause of strokes.

Plus, it's an easy number to get checked - with consultation with a health professional, you can buy and learn to use a device to check it at home - and it involves no needles, scalpels or lab results.

Now, recent study shows a link between treating even mild high blood pressure pays off for stroke prevention: