Hypertension and your heart

We sat down with endocrinologist and researcher Dr. Alex Leung, whose work focuses on ways to improve the quality of care for people living with high blood pressure to discuss hypertension. Continue reading to learn about the connection between hypertension and cardiovascular disease and a sneak peek into Dr. Leung’s research.

What is hypertension and why is it concern?
Hypertension refers to abnormally high blood pressure. This is a very common condition, affecting around one in four Canadian adults. Hypertension is important to recognize and treat because it is a leading cause of heart disease, stroke and premature death worldwide.

What are some of the common misconceptions about hypertension?
Hypertension is often “silent” because few people with hypertension feel unwell until they develop late complications. For this reason, hypertension is frequently ignored, even though early recognition and treatment can help prevent later suffering, disability and death. This is a growing problem. It was recently reported that the percentage of Canadian adults living with hypertension who are treated for their condition has dropped to below 75 per cent, and the number with good blood pressure control below 60 per cent. These are the worst treatment and control rates in decades in Canada. As such, there is an urgent need to re-engage the public, health care providers, policy makers and government about the importance of hypertension treatment and control.

Can it be prevented? 
In some cases, hypertension may be prevented. In a recent Canadian study, it was reported that a sedentary lifestyle, eating few fruits and vegetables, being overweight or obese and having diabetes were leading risk factors for hypertension. There is emerging evidence that healthy lifestyle factors— such as having a healthy diet, engaging in regular physical activity and weight management—can help lower blood pressure. But research is needed to see if healthy lifestyle promotion can delay or prevent hypertension over the long-term.

Tell us about your research.
There is an underlying hormonal disorder that causes between 10-20 per cent of individuals with hypertension to retain too much salt. Oftentimes, the source of the salt-retaining hormone can be localized to a benign tumor. When this is the case, surgery to remove the tumor can cure a patient’s hypertension, such that a person’s blood pressure will go back to normal without needing any medications. My research is mainly focused on finding better ways to diagnose and treat patients who have reversible causes of hypertension from such hormonal disorders.

What are some key findings?
In one of our recent studies, we found that people with reversible causes of hypertension are seldom recognized. For example, in Alberta, less than one per cent of patients with hypertension are ever screened for hormonal causes of high blood pressure. Among those patients who are tested and shown to have high levels of salt-retaining hormone, less than half are treated. This is a big problem because treatment can be life-changing and life-saving. Addressing this problem, my colleagues and I are working hard to find ways to simplify the steps needed to test patients for reversible causes of hypertension and to improve access to care for Albertans.

Why is this such important work?
In a recent Canadian survey, patients, caregivers and health care workers named several priorities for high blood pressure research. There was an expressed desire to find ways to reduce or eliminate the need for blood pressure-lowering medications and to identify the best treatment strategy for different types of high blood pressure. My research directly addresses these priorities with the ultimate goal of improving quality of life and reducing heart attacks and strokes in many people suffering from high blood pressure.

Tell us one thing you wish we all knew. 
Hypertension can be serious if left untreated, but thankfully there are many highly effective treatments available. We cannot afford to be complacent. It is important for everyone to be periodically screened for high blood pressure and to treat the condition if it’s present.