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Why is high blood pressure a 'silent killer'?
01:29 - Source: CNN
CNN  — 

Want to live a longer, healthier life? One way is to keep your blood pressure at optimal levels as you age – preferably below 120 systolic (the top number) and 80 diastolic (the lower number).

That’s especially important during the pandemic, because having high blood pressure is one of the possible risk factors for developing a more severe case of Covid-19, according to the US Centers for Disease Control and Prevention.

You may be able to control your blood pressure, a new study finds, by improving your score on a metric of seven heart-healthy behaviors – doing just one appears to cut hypertension risk by 6% as you age.

“High blood pressure is among the most common conditions in the U.S., and it contributes to the greatest burden of disability and largest reduction in healthy life expectancy among any disease,” said Dr. Timothy B. Plante, the lead author of a new study published Wednesday in the Journal of the American Heart Association, in a statement. Plante is an assistant professor in the department of medicine at the Larner College of Medicine at the University of Vermont in Burlington.

Plante and his colleagues followed nearly 3,000 middle-aged Black and White adults without high blood pressure for nine years. The adults were part of a longitudinal study called the the REasons for Geographic and Racial Differences in Stroke, also known as REGARDS.

At the end of the nine years, the study found that each one-point increase in seven healthy lifestyle steps recommended by the American Heart Association was associated with a 6% lower risk of high blood pressure.

Life’s Simple 7

Called Life’s Simple 7, the AHA metric evaluates heart health by looking at four health behaviors:

  1. Keeping your weight as measured by body mass index (BMI) at a healthy level between 18.5 and 24.9
  2. Getting at least 150 minutes a week of moderate physical activity or a combo of moderate and vigorous, or 75 minutes a week of vigorous intensity
  3. Eating a heart-healthy diet full of fruits and vegetables and low in salt, fat and sugar
  4. Stop (or never start) cigarette smoking

The AHA tool then folds in three additional health factors for a total metric:

  1. Current blood pressure levels – hopefully below 120/80, which is normal, or 130/80, which is considered elevated but not hypertensive
  2. Cholesterol levels today are calculated based on overall risk when combined with such health metrics as blood pressure, smoking status, diabetes status and other factors. “The only ‘real’ current threshold is an LDL of 190 mg/dL as the upper end of what’s tolerated among folks without prior cardiovascular disease,” Plante wrote via email.
  3. Fasting blood sugar levels at 100 milligrams per deciliter or below, which is considered normal

Each of the seven components get a score of poor (zero points), intermediate (one point) and ideal (two points), Plante told CNN.

“By adding up the points for each of the seven components of the LS7 metric, we get a LS7 total score, which ranges from 0 to 14. The higher the score, the more ideal the person’s cardiovascular health is,” he said.

Achieving any one of these seven goals was associated with a lower risk of high blood pressure – success on each additional behavior or measurement should lower risk even more.

“Folks with higher LS7 total scores, who had more ideal cardiovascular health, were less likely to develop high blood pressure 10 years later when compared to individuals with lower LS7 total scores,” Plante said. “A change in seven points would be a really great change, indicating a huge improvement in cardiovascular health.”

You can measure your risk using the tool here.

Another good feature of the program, Plante said, is that people can personalize changes they feel they can tackle, adding on more as their health improves.

“We recommend tailoring step-wise health improvement and lifestyle changes for patients,” Plante said. “For example, patients might not be receptive to quitting smoking today; however, if they are receptive to getting more exercise today, that would be a one-point LS7 score improvement.”

The study could only show an association between heart-healthy behaviors and the lower risk of hypertension, thus the next step is to do a randomized clinical trial to confirm the findings. In the meantime, the AHA hopes Americans will focus on the “Simple 7” at younger ages to reduce their chances of developing high blood pressure later.

“If we can reach more people in younger and middle age with this type of lifestyle assessment, we could be looking at strong improvements in health overall,” said Dr. Donald Lloyd-Jones, chair of the department of preventive medicine at Northwestern University, AHA president-elect and part of the group that developed the Life’s Simple 7 scale and criteria.

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The need for prevention is highest among Black Americans, because they have the “highest rate of high blood pressure among any group in the world and develop the condition at a younger age and with more severity,” the statement said.

“These findings support the current clinical practice recommendations of lifestyle modifications such as eating better, quitting smoking and maintaining a healthy weight to all people, including those without high blood pressure,” Plante said.