Hypertension, or high blood pressure, can be easily missed until it’s too late

More than 70 million Americans are living with high blood pressure or hypertension, according to the Blue Cross Blue Shield (BCBS) Health Index^SM — a first-of-its-kind metric for America’s health. Many sufferers have no idea they have hypertension and an estimated half of all cases of hypertension are uncontrolled.

Out of more than 200 health conditions studied by Blue Cross Blue Shield Association (BCBSA), hypertension has the most significant health impact on Americans. But identifying, treating and preventing the disease continues to be a challenge for medical professionals and patients alike, earning hypertension a reputation as “the silent killer.” Here are a few key facts about the frustrating unknowns and continued myths about the condition.

What is hypertension?

Let’s begin with the basics. Hypertension is high blood pressure and occurs when the pressure of pumping blood through your body’s vessels rises above what’s considered normal. Michael Rakotz, M.D., vice president of health outcomes with the American Medical Association, compares the body’s circulatory system to the plumbing in your house.

“When the pressure in the pipes gets too high that starts to create problems, he says. “High pressure can cause damage in the places the water is flowing into. In the case of hypertension, it’s blood that’s being pumped at high pressure into the liver, kidneys, brain, heart, eyes and throughout the body, putting everything at risk of damage.”

It’s called “the silent killer” for good reason.

The reason so many people with hypertension don’t realize they have the condition is that symptoms often don’t appear until patients experience a significant health crisis and even when people do experience the early warnings of hypertension, they often don’t associate their symptoms with a blood pressure problem.

If left untreated, it could spell disaster for your health.

In addition to significantly increasing your risk of heart attack or stroke, continuously high pressure can lead to kidney failure or even blindness, two conditions that many might not associate with hypertension but are closely connected.

High blood pressure is the main cause of Hypertensive Retinopathy, a condition that causes the blood vessel walls in the retina to thicken, restricting blood flow and causing the retina to swell – ultimately affecting sight.

Often, Rakotz says, hypertension goes unnoticed until the vision is affected. “Sometimes, especially if you’re not getting regular screenings, the first place it’ll show up is during a good eye exam.”

Having hypertension puts you at risk of developing other chronic conditions as well. BCBSA findings show a clear correlation between hypertension and Type 2 diabetes: Those with high blood pressure are 3.6 times more likely to develop the disease. Hypertension sufferers are also 3.5 times more likely to develop coronary artery disease, and 5 times more likely to have heart failure.

Your risk for hypertension increases as you age, but that doesn’t mean youth protects you.

The chances of getting hypertension increase with age, as blood vessels begin to naturally stiffen. BCBS data shows that more than half of insured Americans between 55 and 64 have been diagnosed.

However, rising rates of diagnosis among Millennials show that hypertension simply isn’t a disease for older Americans. BCBSA found that, between 2014 and 2016, hypertension diagnoses among people between 18 and 34 rose by 19%. High blood pressure can be a sign of another medical issue. But more often, it’s the result of poor lifestyle choices.

Your diet could be putting you in jeopardy.

Obesity is a major risk factor for hypertension, but you can still develop the condition if you’re at a healthy weight. For example, having too much sodium can increase the volume of water in the blood, and that drives up blood pressure. Things like fast food, pickles and potato chips have high sodium.

Data from The BCBS Health Index, which tracks the health of Americans on a county level, shows that while hypertension is a problem everywhere, the area most affected is the southeastern region of the United States. This, too, has a lot to do with diet.

A southern diet is one of the leading causes of hypertension, typically it contains more salty foods, fried foods and sugar-sweetened beverages.

A higher toll for hypertension is also seen in rural communities – for 18 to 34-year-olds in rural places hypertension has a health impact 12% above the national average – where a balanced diet can be harder to maintain. Getting access to healthy foods may be difficult for those in rural areas.

Detection is good, but prevention is better.

The best way to combat hypertension is to get an early diagnosis and take action before serious – or fatal – symptoms occur. Get regular screenings, and if your blood pressure is high, work with your doctor to develop a treatment plan that includes lifestyle changes, medication or both.

Even better than treating hypertension is preventing it altogether. That may mean losing some weight, following the DASH Diet, an acronym for ‘dietary approaches to stop hypertension,’ and moving more.

“Change your diet, quit smoking, drink alcohol in moderation and walk for 30 minutes a day,” Rakotz says. “If people can pick one of those things to start, they’ll be that much closer to lowering their risk of hypertension, and anything is better than nothing.”

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