1 in 3 People Have It, Most Don’t Know It—Here’s How to Protect Yourself
The killer you’re ignoring until it’s too late.
1 in 3 people have hypertension (World Health Organization, 2023), a silent disease that significantly elevates the risk of severe health conditions, including heart attack, stroke, heart failure, kidney disease, vision impairment, and cognitive decline such as vascular dementia
Cardiovascular diseases, including hypertension, are currently the leading cause of death worldwide.
Hypertension is called a "silent disease" because it usually does not cause symptoms, which is why many people are unaware they have it until it reaches dangerous levels.
How is Hypertension Diagnosed?
High blood pressure isn’t diagnosed from a single reading. Healthcare professionals follow strict guidelines to ensure accuracy.
In-Office Measurements
At least two separate readings on different days. This is KEY.
Both arms checked initially—higher reading is used.
No caffeine, smoking, or exercise 30 minutes before.
Patient seated, arm at heart level, after 5 minutes of rest.
At-Home or Ambulatory Monitoring
If in-office readings are inconsistent, 24-hour monitoring (ABPM) or Home BP Monitoring (HBPM) helps detect:
Masked hypertension (normal in-office, high at home).
White coat hypertension (high in-office, normal at home).
Diagnostic Criteria (Based on Guidelines)
According to medical guidelines, hypertension is diagnosed when blood pressure is consistently:
≥130/80 mmHg according to the American College of Cardiology/American Heart Association (Whelton et al., 2018).
≥140/90 mmHg according to the European Society of Hypertension (Mancia et al., 2023).
The European Society of Cardiology (ESC) 2024 guidelines have further refined this understanding by introducing a new category of "Elevated BP," defined as readings between 120-139/70-89 mmHg, thereby identifying more individuals at risk for cardiovascular complications (European Society of Cardiology Press Office, 2024).
Monitor your blood pressure regularly and don’t ignore high readings. Your health depends on it
Hypertensive Crisis: Blood Pressure ≥180/120 mmHg
A hypertensive crisis is characterized by a significant and sudden increase in blood pressure, typically defined as a systolic blood pressure of 180 mmHg or higher and/or a diastolic blood pressure of 120 mmHg or higher.
It’s classified into two types:
Hypertensive Urgency (No Organ Damage)
Blood pressure ≥180/120 mmHg without signs of acute organ damage.
May require urgent medication in the emergency department to lower blood pressure safely.
The patient will need a follow-up appointment with their doctor to:
Start antihypertensive treatment if they were not taking any.
Adjust their current medication if already on treatment.
Hypertensive Emergency (Organ Damage)
Blood pressure ≥180/120 mmHg with symptoms and signs of organ damage.
A frequent mistake in clinical practice is underestimating its severity—this condition requires immediate medical attention and additional tests to assess complications such as HEART ATTACK OR STROKE. Without proper evaluation, serious consequences can go unnoticed.
Possible symptoms and affected organs:
Neurological: Severe headache, confusion, feeling very drowsy or fainting, seizures, vomiting, or difficulty moving or speaking.
Eyes: Headache with blurry vision or trouble seeing.
Kidneys: Blood in the urine, extreme tiredness, or loss of appetite.
Heart: Chest pain, difficulty breathing when lying down, signs of heart failure (such as swelling or extreme fatigue), or even shock.
Aortic Dissection: Sudden, intense chest pain that may spread downward.
Pregnancy Complications:
Preeclampsia: Headache, vision changes, upper right abdominal pain, nausea, swelling, shortness of breath, reduced urine output.
Eclampsia: Seizures in a pregnant woman with preeclampsia.
HELLP Syndrome: Upper right abdominal pain, nausea, headache, fatigue, bleeding, jaundice, kidney dysfunction.
Remember: If you have ≥180/120 mmHg with symptoms, you need emergency treatment and additional tests to assess complications
Most Common Causes of Hypertensive Crises
Excessive salt intake in the diet (the sodium it contains is a critical factor in regulating blood pressure)
Missing antihypertensive medication
Inadequate antihypertensive treatment
Stress
Sodium-Free and Low-Sodium Salt: An Option for Hypertension, but With Caution
For those looking to reduce sodium intake, sodium-free salt, composed mainly of potassium chloride, is an option. However, its taste can be slightly metallic and bitter, making it less appealing for some when cooking.
On the other hand, low-sodium salt or Celtic salt contains 33% to 50% less sodium than regular salt, replacing part of the sodium chloride with potassium chloride, while offering a milder and more pleasant flavor.
Warning!
If you have kidney problems or take medications that affect potassium levels, consult your doctor before using these salts, as excess potassium can harm your health.
Hidden Sources of Sodium
While we often think that table salt is our primary source of sodium, over 70% of the sodium we consume comes from processed foods and restaurant meals (American Heart Association, 2024).
At the supermarket, reading labels on processed foods can help you reduce sodium intake without compromising taste or health.
The Dash Diet
The DASH diet (Dietary Approaches to Stop Hypertension) is specifically developed to lower blood pressure and improve cardiovascular health.
It’s based on solid evidence showing how specific eating patterns can help reduce hypertension without medication or in combination with it when necessary.
Why It Works
Reduces sodium intake.
Boosts key nutrients (potassium, calcium, magnesium).
Helps control glucose, cholesterol, and heart disease risk.
Key Recommendations
Sodium: Stay between 1,500–2,300 mg/day.
Fruits & Vegetables: High in potassium to balance sodium.
Low-fat dairy: Provides essential calcium.
Lean proteins: Chicken, fish, tofu, legumes.
Whole grains and fiber: Support heart health.
Healthy fats: Olive oil, fish, nuts, seeds.
Avoid: Added sugars & ultra-processed foods.
Breaking News
In 2024, a study was published revealing a significant association between nutrient deficiency and the risk of all-cause mortality in older adults with hypertension (Sun et al., 2024).
To support your health, prioritize nutrient-dense foods, incorporate fresh produce into your diet, and consider testing for deficiencies.
Despite our best efforts, it’s not always feasible to get all the essential micronutrients through food alone—especially with today’s busy lifestyles, age-related changes in absorption, or dietary restrictions. That’s where smart supplementation can make a real difference.
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To your zenith within,
Sara Redondo, MD, MS
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