Medical Myths: All about hypertension

High blood pressure, or hypertension, is common — both in the United States and further afield. In this article, the latest in our Medical Myths series, we tackle some of the most common misunderstandings.

According to the Centers for Disease Control and Prevention (CDC), in the U.S., around 45% of adults have hypertension. Because there may be no associated symptoms, many people do not know that they have high blood pressure.

The World Health Organization (WHO) report that an estimated 1.13 billion people have high blood pressure worldwide.

Despite hypertension’s increasing prevalence, it is still widely misunderstood.

First, it is worth outlining what blood pressure is. As the CDC explain, blood pressure is “the pressure of blood pushing against the walls of [the] arteries.”

Blood pressure naturally rises and falls. For instance, it tends to rise during exercise and fall during prolonged rest. However, if blood pressure is elevated for longer periods of time, it increases the risk of various health conditions.

This article will tackle eight persistent myths associated with hypertension.

Article highlights:

1. Blood pressure is not serious

Hypertension certainly can be serious. Without treatment, high blood pressure can increase the risk of a range of health issues, including heart attack, stroke, kidney disease, heart failure, angina, vision loss, sexual dysfunction, and peripheral artery disease.

Hypertension causes damage in a number of ways. For example, over time, increased arterial pressure can cause the vessels to become less elastic. In turn, this reduces the amounts of blood and oxygen that reach the heart, thereby damaging the organ.

High blood pressure can also damage the delicate blood vessels of the brain, which increases the risk that they will block or burst.

2. Hypertension runs in my family, so there is nothing I can do

According to research, hypertension does have a genetic component. For instance, the authors of a 2017 study that included data from three generations of participants conclude:

“Early onset hypertension in grandparents raises the risk [of] hypertension in grandchildren, even after adjusting for early onset hypertension in parents and lifestyle factors.”

However, hypertension is not inevitable, even for those who may be genetically susceptible to it. Often, the condition develops due to lifestyle factors, such as diet, which genes do not influence.

The authors of a 2018 study that analyzed genetic, lifestyle, and health data from 277,005 people conclude:

“We show that adherence to a healthy lifestyle (including [healthful] diet, limited alcohol consumption, low urinary sodium excretion, low body mass index [BMI], and increased physical activity) is associated with lower blood pressure regardless of the underlying blood pressure genetic risk.”

They also found that “[a]dherence to a healthy lifestyle is […] associated with [a] lower risk of myocardial infarction, stroke, and composite cardiovascular disease at all levels of underlying blood pressure genetic risk.”

3. High blood pressure is inevitable with age

Hypertension is not inevitable, and it is not a normal part of aging. Although hypertension is more common among older adults, high blood pressure occurs in middle-aged and young adults, too.

Hypertension affects around 7.5% of people aged 18–39 years, 33.2% of people aged 40–59 years, and 63.1% of individuals over the age of 60 years.

Despite this increasing prevalence with age, certain lifestyle interventions can significantly reduce the risk of developing high blood pressure. These include reducing salt intake, exercising regularly, stopping smoking, and eating a healthful diet.

4. I would notice symptoms if I had hypertension

The only way to detect hypertension is to measure blood pressure. There are usually no signs or symptoms to indicate that someone has hypertension.

In the U.S., around 75 million people currently have hypertension. Of these, an estimated 11 million people do not know that they have it.

This is why some experts refer to hypertension as the “silent killer.”

5. I do not use table salt, so I do not need to worry about sodium intake

The WHO recommend consuming under 5 grams of salt each day to help maintain a healthy blood pressure.

They explain that an “estimated 2.5 million deaths could be prevented each year if global salt consumption were reduced to the recommended level.”

However, only avoiding table salt is not sufficient when limiting overall salt intake. It is important to read food labels; salt appears in a wide range of foods, sometimes in very high quantities.

According to the CDC, around 40% of our daily sodium intake comes from these 10 types of food:

• breads

• pizzas

• sandwiches

• cold cuts and cured meats

• soups

• burritos and tacos

• savory snacks, such as chips, popcorn, pretzels, and crackers

• chicken

• cheese

• eggs

Ultraprocessed foods are particularly high in salt. The consumption of these foods — which include soft drinks, chocolate, chips, candy, sweetened breakfast cereals, and packaged soups — may also play a role in the development of other conditions.

For instance, one study in the BMJ that included data from more than 100,000 people found that “a 10% increase in the proportion of ultraprocessed foods in the diet was associated with a significant increase of greater than 10% in risks of overall and breast cancer.”

It is also worth noting that both kosher and sea salt are chemically the same as table salt and, therefore, no less harmful to health.

6. When my blood pressure responds to medication, I can stop taking it

People who take medication to treat hypertension may find that their blood pressure returns to normal. However, for many people, hypertension is a lifelong condition.

It is important to follow the doctor’s recommendations and only reduce or stop taking the medication when they have confirmed that this is the best course of action. According to the American Heart Association (AHA):

“Expect to treat high blood pressure for life. Doctors will sometimes reduce a [person’s] drug dosages after achieving normal blood pressure and maintaining it for a year or more, although it is rare for the treatment to be stopped entirely. Some form of treatment must be continued over a lifetime for good results.”

7. Hypertension is curable

There is currently no cure for hypertension. However, there are ways to manage the condition and reduce its impact on health.

For instance, making the following changes may help:

• reducing alcohol intake

• eating a healthful diet

• exercising

• managing stress

• quitting smoking

• maintaining a moderate weight

• taking medication

8. Only men develop high blood pressure

Although anyone can develop hypertension, men have a higher risk of doing so until the age of 45 years. From 45–64 years, everyone has a similar risk of developing high blood pressure.

After the age of 64 years, however, women seem to have a higher risk of developing hypertension than men.

Summary

Hypertension is both serious and common. Although it can be a lifelong condition, there are many ways to manage it and to reduce the health risks associated with it.

By tackling hypertension-related myths, we can help reduce its impact on society by facing the risk factors head-on and working against them.

Written by Tim Newman on December 14, 2020 — Fact checked by Anna Guildford, Ph.D.

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