Heart Attacker #3: High Blood Pressure

See how high blood pressure affects your heart -- and what you can do about it.

High Blood Pressure and Your Heart

Imagine a peaceful river rolling placidly between cow pastures and cornfields. It rounds a bend and drops into a narrow, rock-walled canyon. Abruptly, the lazy current becomes an angry torrent, scouring the riverbank with sudden force. Now imagine your own arteries -- and their delicate, branching capillaries -- growing narrow and stiff, a consequence of overweight, inactivity, stress, the doughnut and coffee you had for breakfast. Inside, unseen and unfelt, your blood hurtles along like a river squeezed into a stone canyon, banging so forcefully against artery walls that it can injure and weaken them. Ultimately, this pressure can rupture blood vessels in your brain (causing a hemorrhagic stroke) or your abdomen (causing an abdominal aortic aneurysm). It can also enlarge and weaken your heart and damage coronary arteries in ways that can lead to atherosclerosis -- and perhaps even a heart attack.

This is high blood pressure -- a.k.a. hypertension, the grandfather of all cardiovascular risk factors, the original “silent killer” disease. Today, 50 million adult Americans (one in four of us) have it. If you’re not in the club yet, just wait: Another 45 million of us have “prehypertension,” the National Institutes of Health (NIH) warned in 2003. Odds are 90 percent that you’ll develop this raging river in your blood vessels sooner or later. The odds hold true whether you’re a man or a woman. While men under the age of 55 are more likely than women to have high blood pressure, once women reach 55, their blood pressure tends to catch up to and even surpass that of their male peers.

A gruesome 1733 experiment -- in which the Rev. Stephen Hales, a British veterinarian and botanist, attached a thin brass tube to a horse’s neck artery and reported that blood shot nine feet up the tube -- first alerted Westerners to the fact that blood pressure was a force to be reckoned with. In the intervening years, an Italian physician developed a less messy, noninvasive way to check human blood pressure (the oddly named sphygmomanometer, a version of which is still used in doctors’ offices today); insurance companies noticed that higher blood pressure was linked to earlier death; the first low-salt diet -- a monotonous menu of plain rice and fruit -- became the first blood pressure–lowering health food diet in the mid-1940s; and drug companies devised the first successful hypertension drug -- a diuretic that, despite its beginnings in the era of the poodle skirt, is still considered the best first-line drug on the market today. In fact, a landmark 2003 NIH study of 42,418 people with hypertension found that these traditional “water pills” work better than newer, pricier blood pressure drugs -- a finding that sent ripples through the pharmaceutical industry.

What's Your Risk?

Blood Pressure (mm/hg)	Classification
115/75	Ideal
Under 120/80	Healthy
120–139/80–89	Prehypertensive
140/90 and above	Hypertensive

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• High Blood Pressure

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