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ADVANCE Perspective: Nurses

Awakening to the Silent Killer

Published February 1, 2008 4:52 PM by Chuck Holt

I have hypertension. I'm taking meds, exercising a little more, avoiding fatty foods when I can, and doing some of the other things that are supposed to be good for my almost-40-year-old ticker - like drinking more red wine, for example.  

I'm also an editor for ADVANCE for Nurses, including this Web site. And so I've edited numerous articles and otherwise read and understand a lot about the association between high blood pressure and heart attack and stroke.

I even know that I may be a "responder," meaning alcohol might actually raise the triglycerides in my blood from those yummy fatty foods that I can't seem to cut from my diet. To find out, I'll have to quit drinking that red wine for 3 weeks and then have the triglycerides level in my blood tested. It's one of my New Year's Resolutions; I just have to decide which year.

Still, I was surprised when a survey released Jan. 31 indicated most American adults are unaware of the connection between high blood pressure, heart attack and stroke - even though heart disease is the nation's No.1 killer of both men and women

That's right - more than 50 percent of those who responded to a survey commissioned by the National Association of Chronic Disease Directors (NACDD) said they did not associate high blood pressure with coronary events and stroke.

The "Americans and Blood Pressure Survey: A Survey of Americans and Their Knowledge Regarding High Blood Pressure" was conducted on behalf of NACDD by TSC, a division of Yankelovich, Inc.

The survey was conducted by telephone within the U.S. between Jan. 3-6, among 1,018 adults ages 18 and over. Figures for age, sex, race/ethnicity and region were weighted to ensure reliable and accurate representation of the total U.S. adult population. The margin of error for this study was +/-3.1 percent.

This being February and therefore American Heart Month, the survey's results take on a particular significance.

For example, while 72 percent of American adults understand multiple factors contribute to high blood pressure, such as obesity and salt intake, only 42 percent of the survey's respondents associated high blood pressure with heart attack and stroke.

What's more, 76 percent aren't even worried about developing high blood pressure, including 80 percent of Americans over 55!

But according to the American Heart Association, approximately 33 percent of Americans have the condition, noted John Robitscher, NACDD executive director, in a press release announcing the release of the survey.

"In essence, about 20 million American adults are not worried about getting high blood pressure, but are likely to develop it," he said

Funding for prevention efforts a one part of the problem, added David P. Hoffman, director, Bureau of Chronic Disease Services, New York State Department of Health.

"Only 34 states and the District of Columbia receive federal funds for heart disease and stroke prevention," he said. "The rest must rely on state funding and other resources."

Another problem, of course, is high blood pressure typically has no real symptoms, which lends to it the nickname "The Silent Killer."

Some of the other interesting findings from the NCDD survey include:

  • 38% of Americans do not know their current blood pressure reading, including 22 percent of adults over 55.
  • 37% of black respondents and 24% of white reported being diagnosed with high blood pressure.
  • 85% of Americans with high blood pressure control it with medications; 10% rely on diet an exercise alone; and 4% do nothing.

All of which begs the question: What are you doing to educate your patients about the association between high blood pressure, heart attack and stroke, be it in the doctor's office, the ED, community health clinic, long-term care facility or whichever setting you work in?

Please use this blog as the place to share your tips and suggestions with your fellow nurses today - and all American Heart Month long!


My B/P was ranging around 160/102.  I was in my early 30's.  I had it rechecked 6 mos later. It was normal; 120/76.  My doctor asked how I did it. I left my husband.  Now, I wouldn't prescribe this remedy to any of my patients, but I do stress the power of stress!  Meditate, I tell them. Walk, breath, pray, drop the negative friends & find some new ones with smiles on their faces. We too often forget the basics.  I also teach a whole food diet without fried food. Do that long enough & fried food will make you feel ill. Now breathe!

Christine, Community Health - RN March 31, 2008 11:49 AM

Looks like HPB in ADVANCE editors runs in 3s -- I've had it off and on (mostly on) since I hit 45 AND gained those dreaded extra few pounds. I, too, take one pill a day to keep the numbers where they should be, but I know if I exercised more, ate better and lost weight, I'd be in much better shape. But it's much easier said than done, intertia being what it is.

I'd like some suggestions on how to get my fanny off the couch and out the door, even if it's just to walk half an hour every day. I live in California, so weather isn't really an excuse...

Candy Goulette February 28, 2008 3:21 PM

Hey there,

You’re not the only hypertensive editor (gee, is there a connection between editing and high BP? LOL)

Mine developed right after I had my son in March 2006, and I think it had something to do with hormone fluctuations. I had textbook perfect BP before and during my pregnancy. It had me freaked out for a while. Here I was, only 36, a new mom, and now I had an "old person's" health problem.

I’m pretty much under control today (120s/80s). I’m only taking one med – but I know how that can change even though I do everything right.

I try to watch my salt intake and exercise more, with the ultimate goal of losing some extra weight.

I'd like to know if nurses encounter anyone who is depressed about their high BP diagnosis, and what they do to help these people.

Abbey Scott February 4, 2008 2:25 PM

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