General Health

Half of Americans Face Hypertension, the Silent Killer

We’ve all heard about maintaining healthy blood pressure. Height, weight, heart rate and blood pressure are some of the routine “vitals” recorded during any doctor visit. Many foods promise to be heart healthy, and millions of Americans are taking medication to treat high blood pressure, or hypertension. However, millions more Americans still don’t know they have hypertension or aren’t managing their condition. With so many Americans impacted, what makes hypertension a “silent killer,” and what can you do about it?

What Do Blood Pressure Numbers Even Mean?

The beats of your heart create pressure to pump blood through arteries throughout the body. This pressure is measured using two numbers. The first number, called systolic blood pressure, measures the pressure in your arteries when your heart beats. The second number, called diastolic blood pressure, measures the pressure between beats.1

Blood Pressure Category
Systolic Blood Pressure
Diastolic Blood Pressure
<120 mmHg
<80 mmHg
120-129 mmHg
<80 mmHg
Stage 1
130-139 mmHg
80-89 mmHg
Stage 2
≥140 mmHg
≥90 mmHg

When this pressure is continuously above this range it’s considered high, and that condition is known as hypertension. If left untreated, it can damage arteries, the heart and other organs and cause a variety of complications.

The Problem with Hypertension

At a public health level, the problem with hypertension is scale. The Centers for Disease Control and Prevention (CDC) report that nearly half of American adults have hypertension or are taking medication for it. Only a quarter of those with hypertension have their condition under control.2

Hypertension increases the risk of heart attack, stroke and heart disease and is among the most common—and costly—preventative chronic conditions.

Hypertension isn’t limited to older adults either. Research indicates that nearly 1 in 4 adults aged 20 to 44 have high blood pressure. This, along with increasing rates of obesity and diabetes, may be contributing to the increase of strokes among younger age groups.3

On an individual level, the problem with hypertension is how it’s often not discovered until too late.

Hypertension Symptoms


That’s why doctors are so concerned, and why blood pressure monitoring is so important. Unless you’re looking for it, it’s often symptomless—that is until something more serious and costly, like a heart attack or stroke, happens. That’s how hypertension earned the ominous nickname, the “silent killer.” Many people don’t know they’re at risk until it is too late; 1 in 3 adults are unaware they have hypertension.4

Over time, increased pressure strains and changes the artery walls, making them less elastic and stiffer. This stiffness contributes to many cardiac conditions including coronary artery disease, stroke, heart failure and atrial fibrillation. High blood pressure also means that the heart must work harder to move the same amount of blood which strains that essential muscle. High blood pressure itself could also be a symptom of other conditions like hardened arteries or high cholesterol.

While the most immediate risks of hypertension are to the heart and arteries, it can also cause complications from the eyes to the kidneys. Recent research is also identifying a connection between hypertension and an increased risk for dementia.5

The good news is that hypertension is easily detectable and effectively controlled by low-cost treatments and lifestyle changes.

Hypertension Risk Factors

While genetics and family history can play a role, the biggest risk factors come from lifestyle choices and behaviors. One of the main risk factors is an unhealthy diet high in sodium. Diet improvements are one of the most accessible and impactful lifestyle changes. The good news is that a reduced sodium diet for four or more weeks also caused “a significant fall in BP” and reduced cardiovascular complications.6

Typically, excess sodium (as with many nutrients) is harmlessly passed in urine. Due to modern, excessively salty diets, the kidneys are being tasked with filtering more sodium than they can handle. The body’s solution to this problem is to hold onto more water to dilute the sodium until it can be passed. However, this increases the volume of blood flowing through the heart and veins. That extra volume raises blood pressure and makes the heart work harder.7

Other factors include physical inactivity and obesity. Tobacco smoking and excess alcohol use can also raise blood pressure.

However, if caught early, lifestyle changes can make a big difference and prevent additional damage.

Hyper(tension) Vigilance

Regular blood pressure monitoring is the best way to detect this silent killer, especially if you have one or more risk factors. As with so many aspects of health and well-being, an annual doctor visit is a great place to start and will provide a blood pressure screening (and is provided without cost sharing in most health insurance plans). Contact your employee advocacy team with any questions or for help finding a high-quality primary care physician.

Ask your employer if they sponsor workplace health fairs or other wellness initiatives. These could focus on identifying and educating on specific conditions like high blood pressure or may cover a variety of wellness topics. Common programs like weight loss initiatives, exercise incentives or dietary education can address underlying risk factors for the condition.

It’s a smart habit to self-monitor your blood pressure at home (follow these tips!). It’s cheap, easy and can help reduce your risk of complications.

1 Centers for Disease Control and Prevention, “High Blood Pressure Symptoms and Causes”

2 Centers for Disease Control and Prevention, “Facts About Hypertension”

3 Centers for Disease Control and Prevention, “5 Surprising Facts About High Blood Pressure”

4 Centers for Disease Control and Prevention, “5 Surprising Facts About High Blood Pressure”

5 Centers for Disease Control and Prevention, “5 Surprising Facts About High Blood Pressure”

6 Nutrients, “Sodium Intake and Hypertension”

7 Harvard School of Public Health, “The Nutrition Source: Salt and Sodium”

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