More than 126.9 million adults in the United States have some form of heart disease, according to a 2022 report from the American Heart Association (AHA).
The AHA compiles the most current data from the U.S. National Institutes of Health related to heart disease, stroke, and associated risk factors, such as smoking, exercise, diet, cholesterol levels, and weight.
The latest report reveals that in 2019—before the COVID-19 pandemic—there were 874,613 U.S. deaths from heart disease, which includes coronary heart disease, heart failure, hypertension (high blood pressure), and stroke. According to the Centers for Disease Control and Prevention (CDC), heart disease remains the leading cause of death among Americans.
Prevalence of high blood pressure
The AHA determines blood pressure guidelines, which detail what’s considered to be hypertension.
Blood pressure is depicted as a fraction, with a larger number on top and a smaller number on the bottom, separated by a slash. The top number is systolic blood pressure, which measures the pressure inside the arteries when the heart contracts or beats. The bottom number, diastolic blood pressure, measures the pressure in the arteries at rest, between heartbeats.
A blood pressure reading of less than 120/80 mm Hg (millimeters of mercury)—or less than 120 mm Hg systolic and less than 80 mm Hg diastolic—is considered to be normal. Hypertension is defined as a reading above 130 mm Hg systolic or 80 mm Hg diastolic.
About 46.7 percent of U.S. adults have hypertension, according to the 2022 AHA report. That’s approximately 122.4 million adults aged 20 or older. And although the condition is far more prevalent in older adults, many younger adults have it, too. For those between ages 20 and 44 years old, the rate of hypertension is 28.5 percent.
The AHA notes that some Americans are at higher risk for the condition. It’s more common among men than women, and the rate for Black adults is over 55 percent, significantly higher than for other adults.
The report also discussed social determinants, or social factors, that affect the risk of health problems. Exposure to discrimination over a lifetime can put a person at higher risk for developing hypertension, for example. Some other factors that can raise hypertension risk include lack of social network or community, feeling unsafe in one’s neighborhood, working the night shift, and working more than 40 hours per week.
Perhaps most concerning is that although there are many effective treatments for managing hypertension, 38 percent of all U.S. adults with the condition don’t even realize they have it.
Why you need to know your numbers
It’s in your best interest to know your numbers because high blood pressure can lead to a host of problems, such as artery damage, stroke, heart attack, and even kidney and eye damage.
When blood pressure is high, your heart is working harder to pump blood through narrowing arteries. Given enough time pumping against high resistance, the heart will hypertrophy, or grow bigger. This can lead to impaired blood flow, arrhythmia, and sudden cardiac arrest.
The current guidelines are:
Normal: Systolic less than 120 and diastolic less than 80 Elevated: Systolic between 120 and 129 and diastolic less than 80 Stage 1: Systolic between 130 and 139 or diastolic between 80 and 89 Stage 2: Systolic at least 140 or diastolic at least 90
If your reading shows systolic blood pressure above 180 or diastolic above 120, this is considered a hypertensive crisis, and you should seek prompt medical care.
Research suggests that even less extreme blood pressure measurements, such as those in the “elevated” category (or category 1), can lead to significantly higher risks of cardiovascular disease and heart failure in adults, young and old. This means early interventions are important to prevent any further increase in blood pressure levels and to reduce the likelihood of hypertension-related complications, like stroke, vision loss, and heart attack.
Tools of the trade: How to measure your blood pressure
Why is blood pressure measured in millimeters of mercury (mm Hg)? To understand the answer, take a closer look at the blood pressure cuff your healthcare provider (HCP) puts around your arm. The cuff is called a sphygmomanometer and, even today, many contain mercury to measure barometric pressure in the arteries.
The cuff is inflated to squeeze the artery and prevent blood from flowing, then the air is released. When the blood starts flowing again, the HCP will look at the pressure reading and determine the systolic blood pressure, or the pressure during the heartbeat. When the pulse can no longer be heard, that’s the diastolic pressure, or the pressure between beats. HCPs typically check blood pressure at least once more after a reading comes back high.
Many people’s readings are higher in the HCP’s office than they are at home because the experience of being in a medical setting can make people nervous. It’s a phenomenon known as white coat hypertension. Talking while your blood pressure is being monitored or having a full bladder can also throw the reading off.
Your HCP may want you to get a device to monitor your blood pressure at home. Sometimes, a person can have high blood pressure in one arm and not the other due to a problem with their blood vessels. So look for a device that takes measurements from the upper arm and can be used on both arms. It’s a good idea to bring the device to your HCP’s office to make sure it works correctly, and you know how to use it properly.
What you can do about high blood pressure
The AHA recommends that people with high blood pressure take the following actions:
- Quit smoking
- Limit salt intake
- Scale back alcohol consumption
- Eat a well-balanced diet
- Do more daily physical activity
- Maintain a healthy weight
- Manage stress
- Stick to your medication schedule
Your HCP can guide you through the changes you should be making. There is no cure for high blood pressure, but a combination of lifestyle modifications and medication can help manage hypertension and reduce your risk of complications.
Sources: American Heart Association. 2022 Heart D... + 16
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- American Heart Association. A lifetime of discrimination may boost high blood pressure risk in African Americans. Published July 1, 2020.
- Nakagomi A, Yasufuku Y, Ueno T, et al. Social determinants of hypertension in high-income countries: A narrative literature review and future directions. Hypertens Res 45, 1575–1581 (2022).
- American Heart Association. Environment, culture, other social determinants play big role in heart health. Published March 21, 2019.
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