According to the National Stroke Association (NSA), about 76.4 million U.S. adults have high blood pressure. Although the condition, also known as hypertension, usually doesn’t produce any noticeable symptoms, it wreaks havoc within the body over time by increasing pressure inside of blood vessels. The American Heart Association (AHA) warns that hypertension stretches the vessels past their healthy limit, causing microscopic tears and scar tissue that can lead to blockages, blood clots and hardened arteries.
That’s why untreated high blood pressure increases the risk for heart disease and stroke, the first and third leading causes of death in this country. It can damage the kidneys and eyes, too. In an interview with USA Today, Tom Frieden, MD, Director of the Centers for Disease Control and Prevention (CDC) noted that hypertension leads to nearly 1,000 deaths a day in the U.S.
While the toll of hypertension-linked illness and death is enormous on a personal level, there is also a staggering economic cost. Dr. Frieden estimates high blood pressure costs Americans almost $131 billion annually in health care services, medications, and through lost productivity and absenteeism at work.
There is good news about hypertension, however. Once diagnosed, it can almost always be treated, both with lifestyle changes and medication, if needed. But that requires getting the word out about the importance of having blood pressure checked periodically.
Unfortunately, millions of people are walking around clueless that they have high blood pressure. According to the National Heart, Lung and Blood Institute (NHLBI), despite the fact 1 in 3 American adults have hypertension, almost 1/3 don’t know they have it. That means the odds are great that at most every company there are employees with undiagnosed and untreated hypertension.
Understanding the Numbers
"Doctors have long called high blood pressure the silent killer because people can have hypertension and never have any symptoms," Janis S. Coffin, MD, Medical Director of the Family Medicine Center at Georgia Regents Medical Center, tells Client Community. She explains that the healthy threshold for blood pressure has been lowered in recent years because research has shown readings of 120 (the higher, or systolic number) over 80 (the lower, diastolic number) or less are optimal. Systolic pressure is a measurement of blood pressure when the heart beats while pumping blood; the diastolic number refers to blood pressure when the heart is at rest between beats.
Dr. Coffin adds that a blood pressure in the 120 to 139 systolic range and 80 to 89 diastolic range is now considered to be pre-hypertension. “We need to communicate and educate people that if you have pre-hypertension or hypertension, we need to get your blood pressure at 120/80 or lower. That should be the goal for everyone,” she says.
The only way to know if blood pressure is high is to have it measured. A blood pressure measurement is totally painless, non-invasive and only takes a few minutes. It simply involves pumping air into a cuff placed around the arm and reading the measurements as the air is let out.
Dr. Coffin encourages organizations to hold on-site blood pressure screenings. She also recommends that individuals purchase blood pressure monitors, if possible – the kind that fits around the arm rather than the wrist or finger are more accurate – and keep track of their own blood pressure. She asks patients to keep a blood pressure diary of several measurements taken daily that they can bring in when they have a doctor visit.
“This helps us see if treatment and lifestyle changes are working,” Dr. Coffin explains. “And the bottom line is, unless a person has been exercising or is in a stressful situation, we want to see that the blood pressure is 120/80, all the time.” Dr. Coffin, who is Associate Professor of Family Medicine at the Medical College of Georgia at Georgia Regents University, says that normally patients with elevated blood pressure are given lifestyle modifications (such as losing weight if they need to, a low salt diet, exercise, cutting back or stopping alcohol, stopping smoking and increasing physical activity) to try for about three months. “If those measures alone do not bring blood pressure under control, the next step is to start medication, or a combination of medications, until blood pressure is at a healthy level,” she tells Client Community.
Although hypertension can strike the young and slender, there are certain risk factors that up the odds for the condition. Some, like smoking and being overweight, can be changed while others can’t. “There are some risks you can’t do anything about, like your family history, being older than age 35 for men and older than 45 for women, and your race -- approximately 41% of African Americans have high blood pressure compared to 21% of Caucasians,” Dr. Coffin points out. “While lifestyle modifications can help even people with extra risk factors, patients may need to be on pharmaceutical treatment.”
Once on medication and after blood pressure is reduced, some people become lax on complying with their treatment regimen – and that could be a deadly mistake over time. “Patients need to take their blood pressure medicine at same time every day, make sure they take it along when they travel and keep up the lifestyle modifications,” Dr. Coffin says.
Educating Employees
It makes economic sense for an organization to consider the benefits of educating employees about hypertension and pre-hypertension through newsletters and via company websites. The result can be healthier, more productive employees over the long-term.
The CDC encourages employers to offer hypertension information and screening through occupational health clinics, health fairs, and other activities. “Employees who have elevated (blood pressure) values should get therapeutic lifestyle counseling and be referred to clinical care for follow-up. Health care professionals or human resources staff can provide information about the benefits and availability of screening to encourage and motivate employees to be screened," the CDC web site states.
The CDC also suggests organizations make blood pressure monitoring devices available for employees to do their own self-assessments at the workplace with information or training on how to use the monitors. For more specifics on pro-active ways to encourage employees to recognize and control high blood pressure, the CDC offers free a free, downloadable “Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit” and a “Worksite Health ScoreCard” designed to help employers assess and improve health promotion at their worksites.
