Heart disease is the leading cause of death among both men and women in the United States, responsible for 1 in every 4 deaths. Risk factors for heart disease include diabetes, smoking, high cholesterol, obesity, lack of exercise, and high blood pressure. This week, the American College of Cardiology and the American Heart Association released updated clinical guidelines for diagnosis of high blood pressure (hypertension), separating treatment recommendations for individuals with heart disease, diabetes, chronic kidney disease, or those at high risk of having a heart attack or stroke. This change will result in a jump from 32% of the adult US population being diagnosed with this condition to 46%. Previously 140/90 indicated Stage 1 Hypertension, and 130/80 was categorized as pre-hypertension. Now 130/80 is considered stage I hypertension for those with cardiovascular risk factors.
The new guidelines mean that a large number of Americans now have a medically indicated need to place an emphasis on lowering their blood pressure to prevent damage to blood vessels that can lead to heart disease, stroke, and kidney disease. Lifestyle modification is the first line of treatment for early stage hypertension. Action steps and potential drop in systolic (top number) blood pressure include: 1) weight loss (5-10 point drop for every 20 pounds); 2) exercise (30 minutes most days per week can drop 4-9 points); 3) limit salt intake to 2400 milligrams daily (2-8 point drop), 4) drink less alcohol (limit one drink per day for women and two for men can drop 2-4 points); and 5) diet (the DASH diet can drop blood pressure 4-9 points). For those with cardiovascular risk factors, medication may be recommended in conjunction with lifestyle modification.
Call to action for employers: Encourage all your employees and their family members to “know their numbers,” including blood pressure, either through employer sponsored biometrics, primary care office visits, or checking on the machine at the pharmacy. Educate your employees on the dangers of high blood pressure and on the five steps above to decrease blood pressure and risk of heart disease, stroke and kidney disease. Consider providing programs and options to help employees decrease their blood pressure and other risk factors for cardiovascular disease, diabetes and kidney disease. For those that have a blood pressure greater than 130/80 millimeters, encourage them to work with their physician to determine the most appropriate treatment, including lifestyle modification and/or medication. Now is the time for everyone to start reducing their health risks.