Blood pressure and heart health – It’s all about risk

After cancer, heart disease is the leading cause of death in Canada. It accounts for 29% of all deaths (more than 33,000 every year), and nine out of every ten Canadians have at least one major risk factor for heart disease and stroke. Those statistics make you stop and think.

Read: 5 heart smart tips to reduce your risk of heart disease

But the reality is that we’ve made huge strides in the last 60 years to reduce the impact of heart disease, and today, death rates are ¼ what they were in 1960. Not that diseases are competitive by nature, but about ten years ago, heart disease was the leading cause of death of Canadians.

That’s not to say that it’s no longer a problem. In fact, the dramatic drop in the heart-related mortality rates can be directly tied to four things: 1. Declining smoking rates; 2. The widespread use of statins; 3. The widespread use of medication to control high blood pressure; and 4. Advances in the way that heart attacks and strokes are treated when they happen.

It seems silly to say, but if you’re going to have a heart attack, this is the best time to have it. There have been tremendous advances in acute care, including the advent of clot buster drugs, bypasses and stents that have saved millions of lives and allow many Canadians to live long lives after a heart attack or stroke.

While we’re all thankful that modern medicine gives us the opportunity to survive acute cardiac episodes, the ideal is to avoid getting to that point, and heart disease prevention is all about controlling risk factors.

Most of us are familiar with the risk factors for heart disease. Some of the more common factors include:

  • Age (over 45 for men, over 55 for women)
  • Family history of heart disease
  • Smoking or exposure to second-hand smoke
  • Being overweight
  • Lack of physical activity
  • High blood pressure
  • High levels of “bad” (LDL) cholesterol or triglycerides
  • Low levels of “good” (HDL) cholesterol
  • Diabetes
  • Stress

Why is high blood pressure bad for your heart?

High blood pressure (also called hypertension) essentially means that the blood that your heart is pumping through your arteries is pushing against the walls of those arteries harder than it should. This makes your heart work harder, and eventually leads to hardening of the arteries, which makes them more prone to the blood clots that lead to heart attacks and strokes.

What causes high blood pressure?

Remember the risk factors above? Well, many of them are interrelated. Smoking, which is itself a risk factor for heart disease, also increases blood pressure. So does excessive stress, lack of physical activity and being overweight. Other lifestyle choices also contribute to high blood pressure, including drinking too much alcohol, eating too much fat, sugar and salt.

How do I know if I have high blood pressure?

The fact is that it’s very difficult to know if you have high blood pressure unless you go the doctor, a retail store that has a self-testing blood pressure machine or inexpensively purchase a monitor for your home to get tested. There are some symptoms associated with severe high blood pressure, including:

  • headaches,
  • fatigue,
  • confusion, and
  • pounding in your neck, chest or ears.

It’s important to go for regular check-ups, because if you’re experiencing these symptoms, you’ve already let it go for too long.

So, do I need to treat my high blood pressure?

High blood pressure can be controlled in a number of ways. Number one, in general terms, is healthy living. Less alcohol, more fruits and vegetables, less salt, more exercise, less stress. If you have chronic, uncontrolled high blood pressure, however, your doctor is likely to put you on medication to control it.

And that’s where we circle back around the concept of risk. More and more, the medical community, in Canada and around the world, is looking at high blood pressure, high cholesterol, diabetes and other risk factors, not so much as separate conditions, but as part of an equation that equals a healthy heart and cardiovascular system. So, when someone is diagnosed with diabetes, it’s now quite common for a doctor to put the patient on a treatment plan that addresses not only blood sugar, but also blood pressure and cholesterol.

So the answer to “do I need to treat high blood pressure?” is “You need to reduce your risk of heart attack and stroke.” Yes, that means eat less salt. Yes, it means exercise. But it may also mean taking statins to reduce bad cholesterol, even if you haven’t been diagnosed with high cholesterol, because taking statins has been proven to reduce heart risk.

As mentioned, we all have risk factors for heart disease. If not today, as we get older. If enough risk factors add up, you are much more likely to have a heart attack or stroke. Together with your doctor, you should make a plan to reduce or remove as many risk factors as possible.

  • If you have diabetes, high cholesterol and/or high blood pressure, your doctor has probably prescribed medication. Take it.
  • Try to reduce your stress through meditation and relaxation exercises.
  • Quit smoking if you can.
  • If you can’t, losing some weight, getting active and eating better will still reduce your heart risk.

Nobody’s perfect, but if you can improve at least some of your risk factors, that improves your chances of living a long, heart-healthy life.