We all know high blood pressure (HBP) is “bad” — but why, exactly? Given that roughly one in three U.S. adults has HBP, it’s likely you or someone you know needs to take steps to lower their blood pressure. Having a better understanding of this condition, its factors, and how to prevent it, can help you take steps to stay healthy and avoid the costs of chronic hypertension.
What is high blood pressure?
You’ve probably had your blood pressure tested at some point with that tight cuff, and been told your reading is “[number] over [number].” But what do those numbers actually mean?
The top, or first number, represents your systolic blood pressure. This is the amount of pressure that your blood puts on your arteries when your heart beats. The second, or bottom number, is your diastolic blood pressure, which is the amount of pressure your blood puts on your arteries when your heart is between beats. Usually your doctor will pay more attention to your systolic reading, as this is the number that typically increases with age as your blood vessels become stiffer and more plaque builds up inside the vessel walls.
The American Heart Association has a helpful blood pressure reading chart that shows the ranges for healthy, at-risk, and concerning blood pressure numbers. Typically, any reading where your systolic blood pressure is above 120 or your diastolic is above 80 indicates HBP. Unlike other diseases or conditions, HBP usually doesn’t present any outward symptoms, which means it’s all the more important to have it checked at least once a year.
Why is having high blood pressure a problem?
Simply put, HBP puts more strain on your blood vessels and heart, which increases your risk for various cardiovascular events, including heart attacks, strokes, and heart failure. HBP can also lead to vision impairment, kidney damage, sexual dysfunction, and angina (chest pain).
Imagine a garden hose: opening the water spigot all the way increases the force with which the water comes out of the hose, and in turn, puts more wear-and-tear on the hose. Your blood vessels work similarly: blood flowing through your vessels with more force will put more strain on the vessels over time.
What causes high blood pressure?
While there’s no singular cause of HBP, your age is the primary factor. Interestingly, men are more likely to have HBP if they are 45 years old or younger; after age 65, however, the condition affects more women than men. African Americans are more likely to have HBP and at a younger age compared to Latinos or whites.
The 1988 Intersalt study found body mass index and alcohol consumption are strongly, independently, and directly related to HBP — a finding corroborated by other more recent studies. Among the many reasons for losing weight and maintaining a healthy BMI, lower average blood pressure is one of the most immediate benefits.
The cost of high blood pressure
As with most chronic health conditions, having HBP is expensive. The American Heart Association estimates that high blood pressure costs Americans $46 billion annually in healthcare services, medications, and missed days of work. And per person costs can range from $736 to $1,226 per year.
High blood pressure can also put a dent in your overall wealth and retirement strategy. Living with HPB means you’ll likely need to anticipate higher health and life insurance premiums, medications, and more frequent doctor’s visits to regulate your condition. If your condition escalates to a cardiovascular event like a heart attack or stroke, you can expect even higher expenses. Getting your blood pressure under control thus makes good financial sense.
Does salt cause high blood pressure?
A HBP diagnosis often prompts a conversation about switching to a low-sodium diet, including the DASH (Dietary Approaches to Stop Hypertension) diet. Among the recommendations of the DASH diet is limiting sodium intake to 1,500 to 2,300 milligrams per day — that’s about one teaspoon of salt. By comparison, Americans’ average sodium consumption is 3,400 milligrams or higher. When followed, the DASH diet may lower blood pressure by a few points in a couple of weeks, and eight to 14 points over time, according to the Mayo Clinic.
So we’re clear on terms, let’s pause for a moment and discuss the difference between sodium and salt. Sodium is part of the chemical makeup of salt, but by weight, accounts for only 40% of salt. In other words, 2,300 milligrams of salt does not equal 2,300 milligrams of sodium; rather, 2,300 milligrams of salt contains 920 milligrams of sodium. This fact is important to note so that you’re not unnecessarily limiting the amount of salt you put on your food, but also because sodium pops up in other sources besides table salt, including MSG and baking soda.
But how much of a factor is sodium to developing HBP, and in turn, cardiovascular disease, in the first place? A meta-analysis of studies in the American Journal of Hypertension found no evidence that limiting salt intake reduced the risk of heart attack, stroke, or death. In fact, the analysis suggested cardiovascular risk is highest at the low- and high-sodium ends of the spectrum, and best health outcomes were associated with a sodium consumption of 2,645 to 4,945 milligrams per day (equivalent to 1 to 2 rounded teaspoons of salt). Another recent study corroborated this finding, as did a review of randomized controlled trials.
In other words, there’s ample evidence that salt restriction has, at best, a nominal effect on decreasing your blood pressure and preventing death from cardiovascular disease. Evidence also suggests that if your sodium consumption is too low, your risk of cardiovascular events can actually increase.
Why you should up your potassium
The debate over sodium is so heated that other crucial minerals often get overlooked — at the expense of your health. Potassium is one such mineral. Sodium and potassium work together in the body, but the typical American diet tends to be higher in sodium and lower in potassium. Research has shown high potassium consumption not only lowers stroke risk, but when paired with moderate sodium consumption, results in the fewest cardiovascular events of the groups studied.
How can you get more potassium in your diet? Per serving, the following foods are high in potassium:
- Medium sweet potato, 542 mg.
- Medium white potato, 941 mg.
- One cup of tomato sauce (opt for a low-sugar kind), 728 mg.
- One cup of spinach, 540 mg.
- One cup of white beans, 1,189 mg.
- One cup of cooked Swiss chard, 961 mg.
What steps have you taken to lower your blood pressure? Let us know in the Wealth + Health community discussion.
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Things to Consider:
- Get your blood pressure checked if you haven’t recently.
- If you have some weight to lose, take steps to change your diet.
- Avoid processed, packaged foods, which are high in sodium (and usually sugar). Use salt to season whole foods.
- Include potassium-rich foods in your diet.