Published:
February 19, 2024
Maintaining healthy blood pressure and cholesterol levels are two of the most significant actions you can take to reduce your risk for atherosclerotic cardiovascular disease (ASCVD), the leading cause of illness and death in the U.S. That is why diagnosing and treating these risk factors for heart disease is incredibly important.
Although nearly half of Americans have high blood pressure, only one in four has it under control. Just slightly more than half of American adults who could benefit from a cholesterol-lowering medication are currently taking one. At Penn Medicine, researchers and clinicians are working together to improve the cardiovascular health of patients by helping them lower their blood pressure and cholesterol.
Through this blog post, we're connecting you to some valuable information that can help you live a heart-healthy life. To start the conversation you can continue with your health-care provider, it's helpful to understand exactly what ASCVD is.
What is atherosclerotic cardiovascular disease (ASCVD)?
Atherosclerotic cardiovascular disease (ASCVD) refers to health conditions caused by a build-up of plaque in the blood vessel walls. Some of the more common of these conditions include:
- Coronary artery disease: plaque buildup in the arteries of the heart
- Peripheral artery disease: usually plaque buildup in the leg arteries, but can also occur in the arms or pelvis
- Carotid artery disease: plaque buildup in the neck arteries, reducing blood flow to the brain
By controlling the risk factors for these conditions, people can reduce their chance of having a heart attack, stroke, chronic kidney disease, and other illnesses.
What are the risk factors for ASCVD?
High blood pressure and high cholesterol are some of the top risk factors for ASCVD. Complicating the picture is the fact that these conditions are often "silent" issues that aren't noticed until they get very serious. Taking action early can prevent future problems. Calculating your ASCVD risk online using the American College of Cardiology's ASCVD Risk Estimator can be helpful.
What is blood pressure and how is it measured?
Blood pressure is the force of blood pushing against the walls of your arteries. If your blood pressure is higher than normal on a regular basis, you may be diagnosed with high blood pressure, or hypertension. Over time, this can damage your blood vessels and organs like the heart, brain, kidneys, and eyes.
Hypertension is very common. In fact, more than half of American adults have the condition but as mentioned above, many don't know it. Having your blood pressure checked at your doctor's office, or at home with your own monitor, is the only way to learn this valuable information. The good news is that, in most cases, with guidance from a health-care professional, most people can manage their blood pressure to lower their risk for health problems.
Blood pressure is measured as the ratio of two numbers, such as 120/80. The top number is your systolic blood pressure, or the pressure in your arteries when your heart squeezes. The bottom number is your diastolic blood pressure. It is the pressure in your arteries when your heart relaxes. Based on your personal health picture, your doctor will help you determine a healthy blood pressure level for you.
How can a person lower their blood pressure?
Everyone with high blood pressure can benefit from a healthier lifestyle. Even with lifestyle changes, some people also benefit from blood pressure-lowering medications.
When considering lifestyle changes, start with quitting smoking (or never start), exercise, and weight loss. Blood pressure often increases as weight increases. Being overweight can also cause problems with breathing while you sleep (sleep apnea), and sleep apnea can raise blood pressure.
Diet choices are also a big factor. Eating and drinking less sodium (salt) is an important step. For people who drink alcohol, limiting this to less than one drink a day for women or two drinks a day for men can help lower blood pressure.
What is cholesterol?
Cholesterol is a waxy substance the body makes and that is found in many foods. It plays many important roles, such as building cells. Problems arise when the body has too much cholesterol. In general, high cholesterol has no symptoms.
When cholesterol levels remain high, it can lead to atherosclerosis or building up of "plaque" in the body's blood vessels. Plaque limits blood flowing through the blood vessels and sometimes can cause them to become completely blocked. When a blockage happens in the heart, it is called a heart attack. When a blockage happens in the brain, it causes a stroke.
As with blood pressure, maintaining a healthy diet and active lifestyle, as well as quitting smoking, can help lower cholesterol and is recommended for everyone. Many people also benefit from cholesterol-lowering medications which reduce the body's cholesterol production and can stabilize the plaque in blood vessels. Your health-care provider can share the best ways for you to reduce your cholesterol, especially if you have health conditions or other risk factors.
Penn Medicine Healthy Heart: Innovation in heart disease prevention
Research on the value of diligent blood pressure and cholesterol control in partnership with a health-care provider is an important aspect of patient care throughout Penn Medicine. In February 2024, we launched a new program called Penn Medicine Healthy Heart (PMHH) to help elevate the level of ASCVD preventive care for our patients. It was designed after two years of collaborative pilot programs by researchers, clinicians and patients at Penn Medicine locations in Lancaster and Philadelphia. PMHH uses home-based blood pressure monitoring, text messaging, and a multi-disciplinary team available by phone and video visits to guide and coach patients to better cardiovascular health.
PMHH will work with primary care providers across Penn Medicine to identify patients who may benefit from the additional support of the program. After six months, researchers will evaluate whether the program helped patients to successfully lower their blood pressure and cholesterol.
Find a provider who can help you manage high blood pressure, high cholesterol and other conditions that may be keeping you from living your healthiest life.