New guidelines have placed more people into a diagnosis of heart disease, but there are some simple ways you can avoid being one of them.
Dr. Emelia Benjamin studies how heart diseases affect people, but she didn’t think she was one of them.
The Boston University cardiologist was participating in a study at the hospital where she works, and got a readout of some of the results from the tests they had done.
“When I got home and looked at the piece of paper where they had blood pressure, I was shocked,” Benjamin told Healthline.
She bought a device to measure her blood pressure at home and confirmed that it was consistently higher than she’d hoped.
But maybe it shouldn’t have been so shocking.
Nearly half of U.S. adults have some type of cardiovascular disease, primarily high blood pressure, according to the American Heart Association’s latest annual update of statistics.
Benjamin headed the committee charged with writing that report, which was released last week.
She might not have figured she’d be a statistic, but that’s probably true for a lot of people.
The definition of high blood pressure, or hypertension, was changed in 2017 from a reading of 140/90 mm Hg to a reading 130/80 or higher.
And with Americans already struggling with high prevalence of heart disease in previous years, the realization that even more of them are at risk is leading to calls for new, more coordinated action.
That’s led to some controversy and confusion, but that doesn’t mean those with blood pressure between 130 and 140 weren’t already facing health risks.
“We based the hypertension numbers on cardiovascular disease risk, and compared to 120/80, 140/90 gave us a twofold increase in risk, which we thought was unacceptable,” Dr. Robert Carey, who co-chaired the committee that wrote the new guidelines, released in 2017, told Healthline.
So, they lowered the definition to account for those dangers.
“We didn’t predict this when writing the guidelines,” Carey, a professor of medicine at the University of Virginia School of Medicine, said of the AHA finding that nearly half of adults have heart disease. “But if you expand the hypertension numbers, then you would expect this kind of result.”
As for what to do about it, the first thing is lifestyle changes, especially if you’re in the expanded category.
“The vast majority of people in that category have low cardiovascular disease risk and I’d recommend lifestyle changes,” Carey said.
That means drinking less, using less salt, losing weight if they’re body mass index is over 25 and generally being less sedentary, said Benjamin.
“A lot of times people think they have to start running marathons or something,” she said. “But we’re not saying people need to be elite athletes. They just need to go from being sedentary to have some leisure time activities.”
That sounds easy.
Inactivity has reportedly been dropping over the past two decades, but 23 percent of adults still say they don’t get “adequate leisure-time aerobic and muscle-strengthening activity,” according to the AHA statistical update.
Behind those numbers are some more troubling trends.
Screen time is growing. The amount of time adults spent using their smartphones each day grew by more than an hour between 2014 and 2017, according to the report.
And the growth of kids’ screen time may be even more worrying.
“The big, big concern is we really need to be thinking about what’s happening in the health of youth,” Benjamin said.
The new report says the prevalence of children with ideal body mass index (BMI) dropped from 70 percent to 60 between 1999–2000 and 2015–2016.
“I don’t think we were surprised, but we were disappointed,” she said.
And then there’s smoking.
Adults are smoking less, but Benjamin said there has a been a “very disturbing” sharp increase in the use of e-cigarettes among adolescents
Beyond lifestyle changes to combat these growing risks, Benjamin recommends those concerned about high blood pressure get a digital blood pressure monitoring device they can use at home.
Those devices are getting more accurate and reliable.
And if your risk of serious disease is deemed to be high, there are effective medications that can be used.
The key is making sure tools like these are accessible and affordable, Benjamin said, and that’s a problem that needs to be addressed on a higher healthcare system or policy level.
“We’ve got the resources, but we need to make sure people can afford them,” she said.
That means being able to not just track your blood pressure, but to take action in response to the numbers when needed.
And it means access to high quality healthcare in both urban and rural areas.
And working to close the disparities in health outcomes and access faced by people of different races, ages, locations, and incomes.
The AHA report notes, for example, that white men are prescribed statins to combat diabetes and high “bad” cholesterol levels nearly 10 percent more frequently than African-American men, and more than 10 percent more than white or African-American women.
Carey wants to see a plan that identifies the top 10 or so things practitioners can do to fight the increase in heart disease, and then work with the healthcare system to implement it.
That could include simple things such as paying for blood pressure monitors and then getting individuals to use them.
“Everybody needs to pull together both at the individual level and the healthcare system level,” he said.
A new report finds that nearly half of U.S. adults have some form of heart disease, mostly high blood pressure.
The numbers are influenced by a recent expansion of the definition of what constitutes high blood pressure, and Americans were already struggling with heart disease before the new numbers.
But experts say the wider definition is justified and underscores a growing problem.
It will take individual- and society-wide action to fight this issue, they say, but for most of us, that starts with easy lifestyle changes.