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We have heard the phrase “High blood pressure is a silent killer” so often that it’s become cliché. But did you know hypertension is a major risk factor for stroke and cardiovascular disease? 

Blood pressure is the force of your blood against the walls of your arteries as it’s pumped through your body by your heart. High blood pressure, known in medical terms as hypertension, is when blood flows through your arteries with excessive force or pressure. Think of driving your five-speed car to Bismarck in third gear the entire way. Overdrive is not good for your engine, or your heart. 

Your blood pressure reading has two numbers, which together are an indication of whether your blood pressure is within a healthy range. The top number is your systolic pressure, the pressure in your arteries when your heart contracts. The bottom number is your diastolic pressure, the pressure in your arteries when your heart relaxes between beats. 

In all ethnic groups, men have higher mean systolic and diastolic blood pressure compared with women, and through middle age hypertension is more prevalent in men compared with women. “There is a culture of men avoiding seeing a doctor on a regular and timely basis,” explains Garrett Rhule, MD, internist at Trinity Health Western Dakota Clinic. “This helps explain why men are less aware and receive less treatment for hypertension compared with women.” 

The National Health and Nutrition Examination Survey III (2018) documented that only 1 in 5 men had their blood pressure controlled. Death rates are higher in hypertensive men compared with women, and men are at greater risk for stroke, coronary heart disease, heart failure and renal failure. 

Most of us know that 120/80 is considered “normal blood pressure” but what is considered high? In 2017, the American College of Cardiology and the American Heart Association published new guidelines for hypertension management and defined high hypertension as a blood pressure at or above 130/80 millimeters of mercury (mmHg). Stage 2 hypertension is defined as a blood pressure at or above 140/90 mmHg. Studies show men with normal pressure could expect to live 5.1 years longer than those with hypertension; women could plan on another 4.9 years of life. 

Because high blood pressure typically doesn’t have any symptoms, the only way to know for sure if you have hypertension is to get your blood pressure measured. “The benefits of keeping blood pressure under control extend beyond mitigating risk for cardiovascular disease and stroke,” Rhule added. “It also prevents end-organ damage to the brain, heart and kidneys.” 

Hypertension has many risk factors, including:

Age: The risk of hypertension increases as you age. Until about age 64, hypertension is more common in men. In women, hypertension tends to be milder and less common before menopause. 

Family history: Hypertension tends to run in families. 

Being overweight or obese: The more you weigh, the more blood you need to supply oxygen to your tissues. As the amount of blood flow through your blood vessels increases, so does the pressure to your artery walls. 

Sedentary lifestyle: People who are sedentary tend to have higher heart rates. Regular exercise (aerobic) leads to the release of endorphins—natural dilators of blood vessels—that lead to reduction in blood pressure. 

Using tobacco: Smoking or chewing immediately raises your blood pressure temporarily, and chemicals in tobacco damage the lining of your artery walls, causing them to narrow. 

Too much salt or too little potassium in your diet: Too much sodium can cause your body to retain water. Potassium helps balance the amount of sodium in your cells. 

Chronic conditions: Certain chronic conditions such as kidney disease, alcoholism, diabetes and sleep apnea may increase your risk of hypertension. 

You are in the driver’s seat: 

It’s up to you to manage and control your hypertension. Small, manageable steps are the easiest way to create a long-term plan that leads to better health. Rhule recommends reducing alcohol and sodium intake and increasing dietary potassium intake by eating more fruits and vegetables. He also suggests regular aerobic exercise, 30-45 minutes, at least three days per week, which can lead to weight loss and better sleep. 

Here are some tips to help:

Create a healthcare team: Enlarge your circle of influence beyond your primary care provider to include all your healthcare professionals— pharmacists, nurses, and other specialists. 

Set a goal: Create a list of questions you might want to ask such as: What is my blood pressure? What are the best ways to reach my goals? Mention what you are already doing to control your hypertension, including diet changes, medi- cations and exercise, then pick one realistic goal and start working toward it. 

Manage your medications: Medication is an important ally to control and maintain your blood pressure. Make a schedule or create a system to remind you to take your medications regularly. Discuss with your doctor any side effects you experience, if necessary. Never stop treatment on your own. 

Take charge of your health and schedule an appointment with your primary care provider. Targeted management of chronic conditions, such as high blood pressure, puts you in the driver’s seat on the road to wellness.