High Blood Pressure

High Blood Pressure in Alabama

Alabama

High blood pressure (or hypertension) is a major risk factor for heart disease and stroke, the leading and fifth-leading causes of death, respectively. In 2019, more than 102,000 deaths were primarily attributable to high blood pressure. 

High blood pressure often shows no signs or symptoms. Once diagnosed, however, it can be controlled through a combination of diet, exercise and medication. High blood pressure is influenced by risk factors that can be modified, such as smoking, obesity, physical inactivity, poor diet (eating foods high in sodium and low in potassium) and excessive alcohol use. Revised guidelines have lowered the cutoff for high blood pressure, which means that even more people may unknowingly have it. 

In 2017-2018, the total cost of high blood pressure in the United States was $51.1 billion. By 2035, it is projected that the direct medical costs of high blood pressure could reach $154 billion.

Populations with higher prevalences of high blood pressure include:

• Men compared with women.
• Adults ages 65 and older compared with those ages 20-64.
• Black adults compared with white and Asian adults. Research suggests that this is likely due to stress caused by social and economic factors such as racism rather than biological differences. Additionally, Black adults are more likely to develop high blood pressure at a younger age than white adults. 
• Adults with lower socioeconomic status compared with those with higher socioeconomic status.

High blood pressure is an ideal target for prevention and control strategies, as it is a risk factor for heart disease and stroke that can be changed through lifestyle modification and health care interventions. Individuals can reduce their risk of or manage existing hypertension by:

• Taking blood pressure medication as prescribed by their health care provider.
• Reducing dietary sodium intake. Reducing sodium intake to the recommended guideline of less than 2,300 milligrams per day for adults could prevent 11 million cases of high blood pressure and save $10 to $24 billion in medical costs annually.
• Increasing physical activity.
• Quitting smoking.
• Getting screened every two years or as suggested by a doctor.

Interventions promoting education and treatment for high-risk populations, such as barbershop interventions for Black men, have been shown to be effective and sustainable.

Healthy People 2030 has multiple cardiovascular health objectives, including reducing the proportion of adults with high blood pressure and increasing control of high blood pressure in adults.

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Brondolo, Elizabeth, Erica E. Love, Melissa Pencille, Antoinette Schoenthaler, and Gbenga Ogedegbe. “Racism and Hypertension: A Review of the Empirical Evidence and Implications for Clinical Practice.” American Journal of Hypertension 24, no. 5 (May 1, 2011): 518–29. https://doi.org/10.1038/ajh.2011.9.

“Cardiovascular Disease: A Costly Burden for America — Projections Through 2035.” American Heart Association CVD Burden Report. Washington, D.C.: American Heart Association, 2017. https://www.heart.org/-/media/files/get-involved/advocacy/burden-report-consumer-report.pdf.

Muntner, Paul, Cora E. Lewis, Keith M. Diaz, April P. Carson, Yongin Kim, David Calhoun, Yuichiro Yano, Anthony J. Viera, and Daichi Shimbo. “Racial Differences in Abnormal Ambulatory Blood Pressure Monitoring Measures: Results From the Coronary Artery Risk Development in Young Adults (CARDIA) Study.” American Journal of Hypertension 28, no. 5 (May 1, 2015): 640–48. https://doi.org/10.1093/ajh/hpu193.

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Tsao, Connie W., Aaron W. Aday, Zaid I. Almarzooq, Alvaro Alonso, Andrea Z. Beaton, Marcio S. Bittencourt, Amelia K. Boehme, et al. “Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association.” Circulation 145, no. 8 (February 22, 2022). https://doi.org/10.1161/CIR.0000000000001052.

U.S. Department of Agriculture and U.S. Department of and Health and Human Services. “2020-2025 Dietary Guidelines for Americans.” Washington, D.C.: U.S. Department of Agriculture and U.S. Department of Health and Human Services, December 2020. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf.

Victor, Ronald G., Ciantel A. Blyler, Ning Li, Kathleen Lynch, Norma B. Moy, Mohamad Rashid, L. Cindy Chang, et al. “Sustainability of Blood Pressure Reduction in Black Barbershops.” Circulation 139, no. 1 (January 2, 2019): 10–19. https://doi.org/10.1161/CIRCULATIONAHA.118.038165.