Blog 2 – Hypertension: A Persistent Problem We Can Address
August 18, 2021 – Most of us know hypertension—high blood pressure—is one of the most common adverse health conditions affecting humankind. Over time, it can lead to chronic disease, catastrophic events, and even death.
Most of us also know that hypertension can be prevented, or at least managed to prevent catastrophic consequences. So why is unmanaged high blood pressure still such a problem today, including in the workplace? And what can employers do to help address it?
One clear reason for the persistence of hypertension is many individuals, especially younger people, don’t know they have the condition. Other reasons include individuals’ neglect of the problem once they find they have it and resistance to change. And while employers are limited in their ability to directly impact an individual’s health, employers can influence these factors and reduce the prevalence and impact of hypertension on their workforces.
High blood pressure affects one in three adults, according to the Johns Hopkins Bloomberg School of Public Health. In the US, roughly 45 percent of adults in the US have hypertension or are taking medication for the condition, according to a study by the US Centers for Disease Control and Prevention (CDC).
According to Dr. Ernie Vesta, Chief Medical Officer of Veritas Healthcare Management, hypertension is by far the single most prevalent hazardous health risk while also being the most controllable when managed correctly.
Blood pressure—the amount of pressure exerted by blood pumping through the blood vessels—is measured in a range using a scale reflecting the pressure exerted by a column of mercury. Two measures define the range: the systolic number, representing the pressure exerted when the heart pumps blood out through the arteries, and the diastolic number, which is the pressure when the heart is resting between beats.
A blood pressure reading of 120/80 (systolic/diastolic) is considered normal. There are levels of high blood pressure, and most medical professionals consider readings of 140/90 or higher to indicate hypertension. (See an American Heart Association chart presenting blood pressure categories and readings here.)
Over time, high blood pressure causes the heart to work harder, making it larger, stiffer and less efficient, potentially leading to heart failure and other problems. Twenty years of unmanaged hypertension (pressure above 140/90), for example, can damage the filters in the kidneys, resulting in renal failure and the need for kidney dialysis, according to Dr. Vesta. More than half a million people in the US are on dialysis due to kidney failure, he said, and hypertension is second only to diabetes as a leading cause of kidney failure.
Few people consider that they may have high blood pressure, because hypertension starts out producing no symptoms. Typically, the point at which hypertension produces symptoms is at the onset of a serious medical problem, including heart attack or stroke. That is why hypertension is known as “the silent killer.”
Hypertension is commonly considered a condition of older, unfit adults. The truth, however, is high blood pressure can also be found among active youth, especially obese children, as researchers found.
The harmful combination of factors—lack of consideration that hypertension may be present, and absence of symptoms—enables high blood pressure to persist and the risk of serious health problems to grow.
Addressing the problem starts with knowing the condition is present. Starting to measure and monitor blood pressure early on—when people are in their 20s or 30s or even younger—can dramatically reduce the risk of medical problems, especially severe, debilitating issues later in life. And since arteries lose their elasticity as people age, more frequent blood pressure checks are important for older populations.
Once identified, steps can be taken to mitigate the risk of health problems, such as changes in diet, lifestyle and physical activity, increased sleep and reduced stress. More challenging cases may require medication, which, according to the CDC, is considered one of the most cost-effective methods of controlling high blood pressure.
Therefore, employers who recognize the many benefits of improving the health of their employee populations would be wise to invest in efforts and resources to help prevent, identify and address the incidence of hypertension. Carefully crafted and managed programming over time can get the job done effectively.
What an Employer Can Do:
Veritas Healthcare Management recently discussed hypertension in a podcast with Dr. Vesta. Find the podcast, along with other helpful resources, on the Resources page of the Veritas Healthcare Management website here. To receive updates when new blogs or podcasts become available, subscribe here.
More information, as well as data on the incidence and impact of hypertension, is available on the CDC website here (https://www.cdc.gov/bloodpressure/index.htm).
To learn more about hypertension, there are many good resources, including the National Heart, Lung and Blood Institute page on high blood pressure: https://www.nhlbi.nih.gov/health-topics/high-blood-pressure