Nearly half of U.S. adults deal with some form of cardiovascular disease. Cardiovascular disease is comprised of coronary heart disease, heart failure, stroke and high blood pressure. According to the American Heart Association’s Heart and Stroke Statistics 2019 Update, 121.5 million Americans, or about 48.5 percent, dealt with heart or blood vessel disease as of 2016.
Cardiovascular disease remains the leading cause of death globally. After decades of a steady decline in the U.S., CVD deaths are on the rise (840,678 deaths in 2016 up from 836,546 in 2015), although worldwide, the number of people dying from CVD was lower in 2016 (17.6 million) than the previous year (17.9 million). In 2018, Cardiovascular disease, listed as the underlying cause of death, accounts for nearly 836,546 deaths in the U. S. That’s about 1 of every 3 deaths in the U. S.
This year’s reported prevalence of CVD is a significant increase than in previous years, mainly driven by the way high blood pressure has been redefined. The 2017 American Heart Association/American College of Cardiology hypertension guidelines updated the definition of high blood pressure as a reading of 130/80 mm Hg, from the previous definition of 140/90 mm Hg because it is such a significant risk for cardiovascular disease and stroke. The problem is most people have no idea they have high blood pressure until it’s tested. It’s often called ” the silent killer” because there are rarely any signs or symptoms.
“As one of the most common and dangerous risk factors for heart disease and stroke, this overwhelming presence of high blood pressure can’t be dismissed from the equation in our fight against cardiovascular disease,” said Ivor J. Benjamin, M.D., president of the American Heart Association and director of the Cardiovascular Center at the Medical College of Wisconsin in Milwaukee. “Research has shown that eliminating high blood pressure could have a larger impact on CVD deaths than the elimination of all other risk factors among women and all except smoking among men.” The good news is the study found significant declines in smoking, a major risk factor for developing heart disease. From 2015 to 2016, 79 percent of adults were nonsmokers, up from 73 percent in 1999-2000.
And don’t forget the importance of sleep. Recent data also stressed the importance of sleep. Too much or too little sleep (more than 8 hours or less than 7 hours per night) was also associated with a greater risk of death from all causes in 43 studies. Findings indicate that both short and long sleep duration is associated with an increased risk of all‐cause mortality and cardiovascular events.
For many of my patients the biggest question is – how do I learn my blood pressure numbers? The easiest way to start is in a comprehensive physical with your provider. But occasional follow-up checks on your own are also imperative, since it may not be the same every where or every time. I’ve never been a fan of wrist cuffs and now there’s data showing concerns that blood pressure measured at the wrist is higher than pressures measured at the upper arm. Current hypertension guidelines are based on blood pressure measured with a brachial cuff, the kind typically used in doctor’s offices, and applied on the upper arm. This is to get as close to the heart pressure as possible. But many devices used by patients at home, including the increasingly available wearable monitors, measure blood pressure at the wrist and other locations.
Research reported in the journal Hypertension measured blood pressure consecutively at the upper arm and wrist in 180 middle aged and older individuals while they underwent coronary angiography. Meaning they actually checked the pressure in the heart at the same time they measured it on the extremity. Systolic blood pressure – the top number in a blood pressure reading that reflects pressure within the arteries when the heart beats – averaged 5.5 to 12.9 mmHg higher at the wrist than at the upper arm, but went as high as 20 mmHg. The magnitude of variation between individuals was substantial. For 46 percent the readings varied by 5 mmHg or more. This could significantly impact your diagnosis or medical regimen. If in doubt, bring your cuff to the next appointment with your healthcare giver and see how it measures up. You can also get checked at neighborhood fire departments and pharmacies.
This study feeds into a bigger story on the need to improve the accuracy of blood pressure devices in general since high blood pressure is such an integral part of defining cardiovascular disease. Research shows approximately 80 percent of all cardiovascular disease can be prevented by controlling high blood pressure, diabetes and high cholesterol, along with adopting healthy lifestyle behaviors such as not smoking. Eating a healthy diet, engaging in physical activity and maintaining a healthy weight could have the most impact as they contribute to multiple conditions.
When was the last time you or your loved ones had a complete physical, discussed your personal and family history, and had lab drawn to rule out issues? Make sure you’re not the 1 in 2 suffering from a “silent killer” that can be prevented if treated early.