NEED TO KNOW
SPECIAL ISSUE: HIGH BLOOD PRESSURE
WORDS - Diana McDonnell
ILLUSTRATION - Haochen Zhao, Dongyan Xu

Hypertension, also known as high blood pressure, occurs when pressure in the arteries (blood vessels) is too high. This happens when the walls of the arteries are damaged or thickened, which makes the space for blood to pass through narrower. While there are often no symptoms of hypertension, examples of symptoms that someone may experience are headaches, shortness of breath, and palpitations. Palpitations are the sensation of feeling your heart beating in your chest, usually too fast or too hard. 

High blood pressure is concerning even if someone is not having any symptoms. Because arteries carry oxygenated blood from your heart to other parts of your body, high blood pressure can affect your whole body. If hypertension is uncontrolled over a long period of time, it can lead to many other health concerns. It can physically change the anatomy of the heart over time, causing the left ventricle wall to become thicker, increasing the risk of heart problems. Having high blood pressure can also increase the risk of heart attack, stroke, and chronic heart failure. Uncontrolled high blood pressure can increase risk of chronic kidney disease, glaucoma, vision loss, osteoporosis, and sexual dysfunction. The risk for all of these issues can be reduced by controlling one’s blood pressure. 

Risk factors for high blood pressure are usually split into two categories: controllable and uncontrollable. Uncontrollable risk factors include personal factors such as age, family history, assigned sex at birth, race, and environmental factors such as high levels of pollution and lack of access to fresh food. Controllable or modifiable risk factors can include physical activity, food choices, alcohol, tobacco, and other drug use.  

Hypertension itself is considered a modifiable risk factor for other diseases. It’s considered the most modifiable risk factor for all causes of death, after cigarette smoking. This means that if you can maintain a healthy blood pressure, you can prevent many other dangerous health concerns. 

Race as Risk Factor 
Racial health disparities relating to hypertension in BIPOC is a public health issue. Despite improvement in awareness and treatment of hypertension, Black people are still more likely to have hypertension-related diseases and complications. The complications vary and can worsen for a number of reasons that are tied to systemic inequities in our society. These include lower quality health insurance, substandard care from health care providers, limited access to nutritious food, lack of access to safe outdoor spaces, and more. Chronic stress endured by Black communities in a white supremacist society can also increase blood pressure.    

Systemic racism in the American health care system is also likely to play a major role. For example, in Baltimore, Maryland, Black non-Hispanic residents reported having no insurance coverage more than twice as frequently as white residents (10.3% versus 4.2% of residents, respectively), and as many as 34% of Hispanic residents reported not having insurance. Research shows that simply having health insurance helps communities understand and manage their blood pressure. Increasing insurance coverage among Black and Hispanic people could help to reduce their rates of hypertension.