Call it a health numbers game. Knowing just a few key metrics can provide a pretty accurate picture of your current cardiac fitness—and give you ongoing motivation to maintain healthy heart numbers and improve less healthy ones.
“It’s important to remember that all of these numbers fall on a continuous scale,” says Johns Hopkins cardiologist Michael Blaha, M.D., M.P.H.“It’s not enough to say you have high or low blood pressure—your doctor is looking at how high or how low.”
How many steps you take per day? Moving a lot improves every other heart-health measure and disease risk, says Blaha. That’s why he often urges walking up to 10,000 steps a day, or almost five miles. Another rule of thumb is to exercise 150 minutes per week. “It’s better to be active than inactive,” Blaha says.
Your blood pressureHigh blood pressure, or hypertension, has no symptoms; it can only be detected by being measured. A score of 120/80 is optimal, and 140/90 is normal for most people. Higher readings mean that arteries aren’t responding right to the force of blood pushing against artery walls (blood pressure), directly raising the risk of heart attack or stroke.
Your non-HDL cholesterol That’s your total cholesterol reading minus your HDL (high-density lipoprotein) cholesterol, a measure of fats in the blood that can narrow and clog arteries to the heart. Lower is better: Aim for a score lower than 130 mg/dL or, if you’re at a high risk of heart disease, lower than 70–100 mg/dL.
Your blood sugar High blood sugar ups your risk of diabetes, which damages arteries. In fact, type 1 and type 2 diabetes are among the most harmful risk factors for cardiovascular disease.
How many hours of sleep a night you get Although there’s no one “right” answer for all, consistently getting the number of hours that works for you helps lower the risk of heart disease, Blaha says. Most people need to sleep six to eight hours a night.
Cardiovascular disease is leading cause of death worldwide; High blood pressure, high cholesterol, dietary risks and air pollution leading causes of cardiovascular disease worldwide.
Ischemic heart disease is the leading cause of cardiovascular death, accounting for 9.44 million deaths in 2021 and 185 million DALYs.
High systolic blood pressure remains the leading modifiable risk factor for premature cardiovascular deaths, accounting for 10.8 million CV deaths and 11.3 million deaths overall in 2021. The all-cause DALYs (disability-adjusted life years) due to high blood pressure were 2,770 per 100,000 people.
Dietary risks accounted for 6.58 million CV deaths and 8 million deaths overall in 2021. Dietary risks include food types that are under-consumed globally (fruits, vegetables, legumes, whole grains, nuts and seeds, milk, fiber, calcium, omega-3 fatty acids and poly unsaturated fatty acids) and over-consumed (red and processed meats, sugar-sweetened beverages, trans-fatty acids and sodium). All-cause DALYs due to dietary risks were 2,340 per 100,000 people.
Central Asia, Central Sub-Saharan Africa and Eastern Europe were the regions with the highest rates of CVD burden attributable to elevated systolic blood pressure. The regions with the highest rates of CVD burden attributable to dietary risk were Central Asia, Oceania and Eastern Europe.
Central Asia had the highest age-standardized total CVD mortality at 516.9 deaths per 100,000. In contrast, high-income Asia Pacific had the lowest age-standardized total CVD mortality at 76.6 deaths per 100,000 people.
Since 1990, Australasia had the largest percent reduction (64.2%) in age-standardized CVD per 100,000 out of all other regions. This percent decrease was highest in ischemic heart disease at 71.8%.
A global study of over 28,000 people has provided the strongest evidence to date that lowering blood pressure in later life can cut the risk of dementia. Dr. Ruth Peters, Associate Professor at University of New South Wales (UNSW) Sydney and Program Lead for Dementia in The George Institute’s Global Brain Health Initiative, said that in the absence of significant dementia treatment breakthroughs, reducing the risk of developing the disease would be a welcome step forward. “Given population aging and the substantial costs of caring for people with dementia, even a small reduction could have considerable global impact,” she said. “Our study suggests that using readily available treatments to lower blood pressure is currently one of our ‘best bets’ to tackle this insidious disease.”
Dementia is fast becoming a global epidemic, currently affecting an estimated 50 million people worldwide. This is projected to triple by 2050 – mainly driven by aging populations.It is currently estimated to cost US$20-$40,000 per person with the condition each year.Dr Peters explained that while many trials have looked at the health benefits of lowering blood pressure, not many included dementia outcomes and even fewer were placebo-controlled – considered to provide the best level of evidence.
The researchers traced high blood pressure’s association with declining brain function over years, in data from six large studies that they pooled and analyzed. They show that blood pressure-related cognitive decline happens at the same pace in people of Hispanic heritage as in non-Hispanic white people.
The team had set out to see if differences in long-term blood pressure control explained why Hispanic people face a 50% higher overall risk of dementia by the end of their life than non-Hispanic white people in the United States.
But the new findings suggest that other factors may play a bigger role in that disparity.
When high blood pressure was induced in young mice, they had bone loss and osteoporosis-related bone damage comparable to older mice, according to new research presented today at the American Heart Association’s Hypertension Scientific Sessions 2022 conference, held Sept. 7-10, 2022, in San Diego. The meeting is the premier scientific exchange focused on recent advances in basic and clinical research on high blood pressure and its relationship to cardiac and kidney disease, stroke, obesity and genetics.
High blood pressure and osteoporosis are prevalent diseases, and people may have both at the same time. In this study, researchers examined inflammation associated with high blood pressure in mice and found it may be connected to osteoporosis.
Taking blood pressure readings from both arms and using the higher reading would more accurately capture who has high blood pressure – and is at increased risk for cardiovascular disease and death – than relying on readings from a single arm, new research suggests.
While current recommendations call for using the higher arm reading, there was previously no evidence in the scientific literature to support the practice, which isn’t routinely followed, according to the study. The findings appeared this week in the American Heart Association journal Hypertension.
“If you are only doing one arm, you can’t know which is the higher-reading arm,” said lead study author Christopher Clark, a clinical senior lecturer in primary care at the University of Exeter Medical School in Devon, England. “And if you don’t catch high blood pressure, you can’t treat it. We can now support the adoption of using the higher reading from both arms.”
Nearly half of U.S. adults have high blood pressure, also known as hypertension. Blood pressure is considered high if the systolic reading – the top number – is 130 mmHg or more, or the diastolic reading – the bottom number – is 80 mmHg or more. High blood pressure is a risk factor for heart disease, heart attacks and strokes.
In a 2019 scientific statement detailing proper blood pressure measurement, the AHA recommended taking readings from both arms during an initial patient visit and using the arm with the higher reading for measurements at subsequent visits. The statement also called for making sure to use the proper cuff size based on the patient’s arm circumference, among other guidance.
iSIPsmarter, a web-based program developed by University of Virginia School of Medicine researchers, has been helping southwest Virginia adults reduce their consumption of sugary drinks. So far, the trial has enrolled 170 adults or about 70% of its goal.
“There are chemotherapies that can damage the heart, and radiation to the chest can also affect the heart,” said lead researcher Dr. Roberta Florido, director of cardio-oncology at Johns Hopkins Medicine in Baltimore. “So it’s possible that these therapies, in the long run, increase the risk of cardiovascular disease.”
Exposure to man-made chemicals found in common household products and in soil, air, food and water may raise the risk for high blood pressure in middle-aged women, a new study suggests.
The study found middle-aged women with higher blood concentrations of per- and polyfluoroalkyl substances, or PFAS, were 71% more likely to develop high blood pressure than their peers with lower levels of these substances. The findings appeared Monday in the American Heart Association journal Hypertension.
“PFAS are known as ‘forever chemicals’ because they never degrade in the environment and contaminate drinking water, soil, air, food and numerous products we consume or encounter routinely,” lead study author Ning Ding said in a news release.
Many people with heart failure also have diabetes or high blood pressure. But new research suggests those conditions, even when treated, aren’t well controlled, placing people at risk for worsening heart problems, according to the American Heart Association (AHA).
“We know that controlling hypertension and diabetes is critical for people with heart failure,” said Dr. Madeline Sterling, a primary care physician at Weill Cornell Medicine in New York City. “But few studies have been able to ascertain how well those risk factors have been controlled. This study really takes a big step forward in doing that.”
Sterling wrote an editorial accompanying the study that appeared in the American Heart Association’s journal Circulation: Heart Failure.
Heart failure occurs when the heart can’t pump as well as it should and fails to deliver enough oxygen to the body, making it harder for people to perform everyday tasks. Hypertension, another name for high blood pressure, and diabetes are major risk factors for heart failure, which affects more than 6 million people in the U.S., especially those who have other heart problems or who have had heart attacks.
In the new study, researchers analyzed 18 years of data from the National Health and Nutrition Examination Survey, a series of federal studies assessing the prevalence of major diseases and their risk factors among U.S. adults.
While just 8% of 1,423 people diagnosed with heart failure had poor glycemic control, defined in the study as a hemoglobin A1C level of 8% or higher, 21% of those being treated for diabetes failed to meet blood glucose goals. This did not vary by race or ethnicity.
Researchers also found 48% of people with heart failure had uncontrolled hypertension, which the researchers defined as a systolic blood pressure, the top number in a reading, of at least 130. Among people prescribed blood pressure-lowering medication, poor control was even higher, at 51%. Black adults had higher uncontrolled rates than their white peers, at 53% compared to 47%.
That higher rate of poor blood pressure control among Black adults with heart failure was not surprising since it mirrors racial disparities in blood pressure control in the general population, said Dr. Sadiya Khan, senior author of the study, funded in part by the AHA.
“This speaks to a larger problem, which is a systemic failing to control the leading risk factors that account for the greatest number of non-communicable deaths worldwide,” said Khan, an assistant professor of medicine at Northwestern University Feinberg School of Medicine in Chicago.
“The reasons for these disparities are manifold,” said Dr. Leah Rethy, a resident physician at the University of Pennsylvania Perelman School of Medicine and lead author of the study. They include the history of structural racism in the U.S., which is largely responsible for disparities in access to health care, proximity to green spaces where people can safely meet exercise goals and “all sorts of things that influence somebody’s life course up until the time they get heart failure,” she said.
While the vast majority of people in the study had insurance, they also reported incomes below the poverty line, which could affect their access to quality care or the ability to pay for medications, said Sterling, who was not involved in the research. The study also did not track whether people being treated for high blood pressure and diabetes were actually taking the medications prescribed to them.
The study documented only the prevalence of uncontrolled blood pressure and poor glycemic control, not why those risk factors were uncontrolled, Rethy said.
“We think there’s probably a number of reasons that include a lack of understanding or focus from providers about the importance of blood pressure control, but also perhaps a lack of accessibility to consistent and affordable primary and specialty care for adults with heart failure,” she said, “particularly those under age 65 who don’t qualify for Medicare.”
Sterling added that “it’s actually quite hard to control these risk factors. It’s not just a matter of giving people medications. This study is shedding light on this.”
Many people who have heart failure are older, frail and may have cognitive issues, so it may be difficult for them to perform the extensive self-monitoring needed to manage their health, she said. “A lot is put on patients to manage this at home, and it’s a challenge.”
But that doesn’t mean it’s an insurmountable one, Rethy said. The key is finding ways to help health care professionals and patients put into practice what researchers know about how to get blood pressure and blood glucose levels under control.
“There are many good medications and lifestyle interventions that we know work,” she said. “We shouldn’t think of it as too lofty to achieve. We have access to lots of tools to help fix it.”
More than two-thirds of people who have a type of heart attack not caused by a blood clot also may have undiagnosed heart disease, according to a small study from Scotland.
The study, published Monday in the American Heart Association journal Circulation, focused on people who had what’s known as Type 2 heart attacks, which result from strain caused by an illness such as infections or fast heart rates that can lower blood pressure or oxygen in the blood. But when researchers conducted advanced heart imaging, they discovered study participants also had conditions such as narrowed arteries or weakened heart muscles that were frequently undiagnosed. Fewer than a third of those patients were being treated for heart disease.
“This is the first evidence from a study to demonstrate underlying heart artery disease and heart weakness is common in this condition,” said the study’s senior author Dr. Andrew Chapman of the BHF Centre for Cardiovascular Science at the University of Edinburgh in Scotland.
While nearly half of U.S. adults have high blood pressure (HBP), only 29% think over-the-counter (OTC) pain relievers may raise blood pressure, according to a recent survey commissioned by the American Heart Association, the leading voluntary health organization devoted to a world of longer, healthier lives for all.
While majority of adults in the general population, as well as people with high blood pressure, aren’t sure about the effect of OTC pain medicine on their blood pressure, only a little more than half of those diagnosed with high blood pressure, who take OTC pain relievers (53%) check with their doctor before taking this medicine.
Younger adults (ages 20-40) with high blood pressure had brain changes by midlife (average age 55) that may increase their risk of cognitive decline later in life or over time.
These changes were similar across all races and ethnic groups examined in the study when accounting for the degree of high blood pressure exposure.
The findings suggest health care professionals consider more aggressive high blood pressure treatment for younger adults to prevent brain changes in later life.
High blood pressure among younger adults, ages 20-40 years, appears to be linked to brain changes in midlife (average age 55) that may increase risk for later cognitive decline, according to preliminary research to be presented at the American Stroke Association’s International Stroke Conference 2022, a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health to be held in person in New Orleans and virtually, Feb. 8-11, 2022.
Flavonoids found in plants and plant foods such as berries, apples, tea, wine and dark chocolate are known to offer health benefits, including some protective effects on the cardiovascular system.
A study of over 900 adults in Germany evaluated the quantity and frequency of eating flavonoid-rich foods and measured bacteria in the gut microbiome to determine if there was an association with blood pressure levels.
Researchers determined the participants who consumed higher levels of berries, apples, pears and wine had lower systolic blood pressure levels, which was explained in part by bacteria in their gut microbiome.
Flavonoid-rich foods, including berries, apples, pears and wine, appear to have a positive effect on blood pressure levels, an association that is partially explained by characteristics of the gut microbiome, according to new research published today in Hypertension, an American Heart Association journal.
“Our gut microbiome plays a key role in metabolizing flavonoids to enhance their cardioprotective effects, and this study provides evidence to suggest these blood pressure-lowering effects are achievable with simple changes to the daily diet,” said lead investigator of the study Aedín Cassidy, Ph.D., chair and professor in nutrition and preventive medicine at the Institute for Global Food Security at Queen’s University in Belfast, Northern Ireland.
Flavonoids are compounds found naturally in fruits, vegetables and plant-based foods such as tea, chocolate and wine, and have been shown in previous research to offer a variety of health benefits to the body. Flavonoids are broken down by the body’s gut microbiome—the bacteria found in the digestive tract. Recent studies found a link between gut microbiota, the microorganisms in the human digestive tract, and cardiovascular disease (CVD), which is the leading cause of death worldwide. Gut microbiota is highly variable between individuals, and there are reported differences in gut microbial compositions among people with and without CVD.
A doctor’s presence during a blood pressure reading triggers a “fight or flight” response that can affect the results, say researchers who studied the effect by measuring nerve activity.
“White coat hypertension” – the phenomenon when blood pressure rises in some people who are measured by a medical professional – has been known about for decades. It occurs in about a third of people with high blood pressure.
In a small study published in the American Heart Association Journal Hypertension(link opens in new window), Italian researchers examined the effect’s roots by measuring blood pressure, heart rate and nerve traffic in the skin and muscles with and without a doctor present.
The researchers found a “drastic reduction” in the body’s alarm response when a doctor was not present, said co-lead author Dr. Guido Grassi, professor of internal medicine at the University of Milano-Bicocca in Milan.
High blood pressure, or hypertension, is the leading modifiable risk factor for cardiovascular diseases and premature death worldwide. And key to treating patients with conditions ranging from chest pain to stroke is understanding the intricacies of how the cells around arteries and other blood vessels work to control blood pressure. While the importance of metals like potassium and calcium in this process are known, a new discovery about a critical and underappreciated role of another metal – zinc – offers a potential new pathway for therapies to treat hypertension.
All the body’s functions depend on arteries channeling oxygen-rich blood – energy – to where it’s needed, and smooth muscle cells within these vessels direct how fast or slow the blood gets to each destination. As smooth muscles contract, they narrow the artery and increase the blood pressure, and as the muscle relaxes, the artery expands and blood pressure falls. If the blood pressure is too low the blood flow will not be enough to sustain a person’s body with oxygen and nutrients. If the blood pressure is too high, the blood vessels risk being damaged or even ruptured.
Health Secrets of a SuperAger 