[5 min read]
In this article:
- According to the American Heart Association, some three quarters of people who have high blood pressure are unaware of their condition.
- Black, Hispanic, Native American and Native Alaskan communities have higher rates of uncontrolled high blood pressure exacerbated by disparities in treatment and environmental factors.
- Providence Swedish is home to a unique hypertension clinic for patients with uncontrolled or complex hypertension.
Hypertension, commonly known as high blood pressure, is a significant health concern affecting approximately 116 million adults in the United States. Hypertension is the most prevalent modifiable CVD risk factor and is the leading cause of death and disability worldwide. The condition often progresses silently and can be exacerbated by a diet high in salt and fat, high-stress, sedentary lifestyle and a host of other factors. Genetic predispositions and certain medical conditions can further increase vulnerability to hypertension.
Providence Swedish is home to a unique hypertension clinic, led by Zehryl Sounthala, NP, where patients with uncontrolled or complex hypertension can be referred by their providers for additional support. We recently spoke with Sounthala about the clinic, Its mission and the challenges of addressing this dangerous condition in high-risk communities.
“When the pressure on our artery walls is consistently too high, we are at risk for hypertension,” says Sounthala. “Artery walls can become narrowed by plaque and damaged from high pressures and affect blood flow. Furthermore, the vessels become thickened from uncontrolled blood pressure. This can put you at risk for significant complications, including chronic kidney disease, stroke, and cardiovascular disease. High blood pressure can be fatal if it goes unaddressed.”
Hypertension often goes undetected
Hypertension is often referred to as the “silent killer.” According to the American Heart Association (AHA), three-quarters of people who have hypertension don’t know they have it. That’s because the condition doesn’t cause noticeable symptoms, but it does increase the workload of the circulatory system, which, over time, damages the arteries and leads to plaque buildup. This causes the arteries to narrow, which raises blood pressure.
Racial and ethnic factors can also play a role. Around 55% of Black adults have some of the highest rates of hypertension in the world. People who are Hispanic also have a higher risk of developing hypertension. These disparities are rooted in genetic, socioeconomic, and environmental factors. Minority groups are more likely to encounter barriers to healthcare and live in food deserts where there is limited access to healthy fresh food. Additionally, systemic inequities and cultural dietary habits can heighten the risk. Addressing these challenges is crucial for developing targeted interventions and promoting equitable healthcare practices to reduce the prevalence and impact of hypertension in these communities.
The only way to know whether your blood pressure is too high is to have it checked. If you have high blood pressure, it means blood is flowing through the arteries at higher-than-normal pressure.
“Our blood pressure measures the amount of blood your heart pumps and the resistance to blood flow in your arteries,” says Santhala “The higher the pressure, the harder the heart must work to pump blood.”
Who’s at risk
Risk factors for hypertension include:
- A certain genetic composition
- A family history of high blood pressure
- Being overweight or obese
- Drinking too much alcohol
- Eating a diet high in salt
- Not being physically active
- Older age
Measuring blood pressure & defining hypertension
Blood pressure is measured using two numbers, called systolic and diastolic pressures. Systolic pressure is the top number and measures the pressure in your arteries when your heart beats. Diastolic pressure, the bottom number, measures the pressure in your arteries between your heartbeats when your heart is relaxed.
A new joint guideline from the AHA and the American College of Cardiology advises earlier treatment that includes lifestyle modification and medications as appropriate, recommends close blood pressure management before, during and after pregnancy, and highlights using the new PREVENT™ risk calculator to estimate a person’s cardiovascular disease risk to tailor treatment. The new guidelines also reinforce the importance of healthy lifestyle behaviors, such as eating a nutritious diet, being physically active, and maintaining or achieving a healthy weight.
Normal blood pressure is less than 120/80 mm Hg. If readings consistently exceed 130/80 mm Hg, a diagnosis of hypertension may be considered. It often requires multiple readings over time to confirm high blood pressure due to its potential fluctuation from factors like stress, exercise, and food intake.
Stages of hypertension
Hypertension is classified into stages:
- Elevated Blood Pressure: This stage is characterized by a systolic pressure between 120-129 mm Hg and diastolic pressure less than 80 mm Hg. It indicates a higher risk for developing hypertension.
- Stage 1 Hypertension: Systolic between 130-139 mm Hg or diastolic between 80-89 mm Hg. Lifestyle changes and medication might be necessary at this stage.
- Stage 2 Hypertension: Systolic of 140 mm Hg or higher, or diastolic of 90 mm Hg or higher. This stage requires more intensive medical intervention.
- Hypertensive Crisis: Blood pressure above 180/120 mm Hg. Immediate medical attention is required as it can lead to severe complications.
Symptoms and complications
“Some people experience headaches, chest pressure, palpitations, shortness of breath, , or nosebleeds,” says Sounthala. Patients should speak with their physician or clinician if they experience any of these symptoms. Long-term uncontrolled hypertension can lead to complications such as heart attack, stroke, heart failure, kidney damage and blindness—and it can be fatal.”
- Kidneys: Hypertension can damage the blood vessels in the kidneys, impairing their ability to filter waste and leading to kidney disease.
- Heart: It forces the heart to work harder, leading to thickening of the heart muscle, heart failure, or coronary artery disease.
- Vascular System: High blood pressure can cause hardening and narrowing of the arteries, increasing the risk of stroke and heart attack.
Treatment of hypertension
If readings consistently exceed 130/80 mm Hg after 2 clinic visits, a diagnosis of hypertension may be considered. It often requires multiple readings over time to confirm high blood pressure due to its potential fluctuation from factors like stress, exercise, and food intake. Managing hypertension typically involves lifestyle changes and medication such as diuretics, ACE inhibitors, and beta-blockers. Lifestyle modifications include dietary changes like reducing salt intake, regular physical activity, maintaining a healthy weight, and avoiding tobacco and excessive alcohol. Medications may be prescribed to help control blood pressure.
The Hypertension Clinic at the Swedish Heart and Vascular Institute provides a multidisciplinary team approach to improve blood pressure and reduce risk factors for kidney disease, stroke, heart attacks, and heart failure. The multidisciplinary team includes general cardiology, interventional cardiology, clinical pharmacy, and nurse practitioner. Along with providing target specific medications for BP control, the hypertension clinic provides a procedure called renal denervation. Renal denervation is an additional procedure that may be used to help improve blood pressure for patients that are resistant to medications or have adverse side effects to medications.
To learn more or schedule an appointment, speak with your physician or clinician or contact the hypertension clinic at 206-215-4545.
Learn more and find a physician or advanced practice clinician (APC)
The team of specialists at the Providence Swedish Heart & Vascular Institute has access to the latest treatments and technology and the expertise to know how to use it safely and effectively. Call 206-320-4100 to learn more about the vascular care we offer.
Whether you require an in-person visit or want to consult a doctor virtually, you have options. Contact Swedish Primary Care to schedule an appointment with a primary care physician. You can also connect virtually with your doctor to review your symptoms, provide instruction and follow up as needed. And with Swedish ExpressCare Virtual, you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections and more. You can use our provider directory to find a specialist or primary care physician near you.
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