More than 100 million U.S. adults — almost half — have high blood pressure, according to new statistics from the American Heart Association (AHA). Even scarier, the number of deaths from hypertension rose by nearly 38 percent from 2005 to 2015. “Many people with high blood pressure aren't aware that they have it, and even in those cases that they are aware, their condition isn't well controlled,” says Willie Lawrence, chief of cardiology at the Research Medical Center in Kansas City, Missouri, and a spokesperson for the AHA. However high your own numbers, experts say there are critical things to know about this silent killer.
More people are being diagnosed with hypertension
The sky-high numbers of Americans with high blood pressure is due in part to the fact that standards changed in 2017. And when the American Heart Association and the American College of Cardiology (ACC) redefined blood pressure limits, the new, more stringent standards pushed over 31 million Americans from borderline high blood pressure to bona fide hypertension.
"You're now considered to have hypertension if you have blood pressure of at least 130 for the systolic [top] number or 80 for the diastolic [bottom] number,” Lawrence explains. (Previously, the number was 140/90.)
Experts note there is a solid scientific basis and a real need for the lower thresholds: If all American adults over age 45 were able to keep their blood pressure below the new standard of 130/80, it would prevent 3 million strokes and heart attacks over the next decade, according to a 2018 study published in the medical journal Circulation.
'White coat hypertension’ can be dangerous
Sometimes, people who have high blood pressure at their doctor's office actually have normal blood pressure in other settings, such as their home, a condition known as “white coat hypertension.” But although many doctors dismiss it, new research suggests the in-office spike may portend trouble ahead: Untreated white coat hypertension appears to more than double the risk of dying from heart disease, according to a review published in June in Annals of Internal Medicine.
"It may be that patients with white coat hypertension experience a rise in blood pressure whenever they're stressed,” explains Lawrence. If your blood pressure is frequently high in your doctor's office but normal at home, you may want to consider 24-hour ambulatory blood pressure monitoring, where your physician sends you home with a device that checks your blood pressure every 20 to 30 minutes during the day and hourly at night. This will help your doctor determine whether your blood pressure rises with anything even remotely stressful, or if it's just an in-office occurrence.