From edition.cnn.com
It’s a new year and time for many people to make their health-related resolutions. According to my go-to doctor expert, one of your resolutions should be to find out if you have any chronic medical conditions and address them before symptoms begin.
This approach, of course, is the case for diagnosing cancer, and early detection can help save lives. But people often let other conditions such as high blood pressure and diabetes go for a long time without adequate treatment.
More than 77% of the 119.9 million Americans with hypertension do not have their blood pressure under control, according to the US government’s Million Hearts initiative.
More than 50% of people 30 and older living with diabetes did not take medications for their diabetes in 2022, according to the World Health Organization. Many may not even be aware that they have diabetes; in the United States, the American Diabetes Association estimated in 2021 that of the 38.4 million people who have diabetes, 8.7 million were undiagnosed.
How common are chronic conditions such as hypertension and diabetes? How do doctors diagnose them? Why is it important to identify these conditions and to begin treatment, even if you don’t have any symptoms? What types of treatments, including medications and lifestyle changes, should people consider? And for those who don’t have these conditions, what actions can help prevent them?
To guide us through these questions, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously was Baltimore’s health commissioner.
CNN: How common are hypertension and diabetes?
Dr. Leana Wen: These chronic conditions are very common. In the United States, nearly half of American adults have high blood pressure, also known as hypertension, which is generally defined as blood pressure at or above 130/80 mmHg. More than 1 in 10 Americans have diabetes, and the proportion increases with age; among those 65 and older, about 29% have diabetes.
CNN: Why is it important to diagnose these conditions and to start treatment, even if people have no symptoms?
Wen: Both diabetes and hypertension are major contributing factors to heart disease and stroke, which both fall into the category of cardiovascular disease, the No. 1 killer among Americans, according to the US Centers for Disease Control and Prevention, and a leading cause of deaths worldwide.
Hypertension is frequently referred to as the “silent killer” because it can cause significant lasting damage before people experience symptoms. High blood pressure affects multiple organs. Not only can hypertension add stress to the heart and damage arteries, leading to heart disease, but it also can cause strokes and kidney disease as well as increase the risk of developing dementia. High blood pressure is estimated to cause 7.5 million deaths worldwide each year, according to the World Health Organization.
Diabetes exerts a similar kind of long-term toll on the body. According to the CDC, diabetes is the No. 1 cause of kidney failure and adult-onset blindness and one of the top causes of death among Americans. People with diabetes are up to four times more likely to develop heart disease compared with those who do not have the condition.
CNN: How are these conditions diagnosed?
Wen: Doctors diagnose hypertension through readings taken from a blood pressure cuff. If the initial blood pressure measurement is high, health care providers will take another measurement later during that clinic visit or will ask the patient to come in a separate time to confirm that the blood pressure remains elevated.
Make sure your blood pressure is measured correctly by keeping your feet flat on the floor with legs uncrossed, having your back supported, wearing the appropriate cuff size and having the appropriate arm position. (The cuff is at heart level, and the arm is supported on a desk or table.)
For diabetes, there are two common types of tests. One measures blood sugar at the moment, while the A1C test looks at average blood sugar over the past few months.
It’s important that everyone schedules annual visits with a primary care provider. Providers will check your blood pressure during your visit. If it’s elevated, they may recommend that you self-monitor or that you return for a repeat check. Blood sugar testing may be recommended, too, depending on your age and risk factors.
If you don’t have a primary care provider, you should be able to get these tests done at a community health or pharmacy clinic. Those able to identify a primary care provider should do so to ensure that they have continued care with a trusted provider.
CNN: What are types of treatments that people should consider?
Wen: Hypertension and diabetes are both chronic conditions that are well-researched and for which there are many effective therapies.
For hypertension, there are several classes of medications that use different mechanisms to lower blood pressure. For example, some medications reduce the heart’s workload, while others help rid the body of excess sodium and water, and still others relax and open blood vessels. Some people respond best to one type of medication. Others may require more than one to best control their blood pressure.
For diabetes, the treatment depends on the type of diabetes, and there are two main types.
People with type 1 diabetes lack insulin, which is a hormone that helps the body manage glucose levels, also known as blood sugar levels. These people must take insulin every day.
Individuals with type 2 diabetes, the most common form in which there’s a problem with the way the body uses insulin, can usually start with oral medications. These medications may work by lowering glucose production, improving the body’s response to insulin, and/or helping the body secrete more insulin. Some people with type 2 diabetes also need insulin therapy if their blood sugar goals are not met with oral treatments.
For people diagnosed with diabetes or hypertension, lifestyle changes are also important, as is addressing related conditions. For instance, obesity is a major risk factor for developing both hypertension and diabetes. Lifestyle changes that address obesity also will help with lowering blood pressure and reducing the toll of diabetes.
CNN: What can be done to prevent these chronic diseases?
Wen: The same lifestyle changes that people with the diseases should implement are also the best preventive measures for people who want to forestall these diseases.
First, maintain a healthy weight. People who have difficulty doing so through diet and exercise alone may want to inquire with their health care providers about medications that can treat obesity.
Second, aim for at least 150 minutes of moderate-intensity physical activity a week. Those who cannot yet reach 150 minutes should work to increase duration and intensity, while keeping in mind that some is better than none. Studies have shown that even half of the recommended amount can lower the risk of developing chronic diseases.
Third, reduce your consumption of unhealthy foods like saturated fats, ultraprocessed foods and sugary drinks. It may be difficult to cut out these foods altogether, but try to aim for whole foods like vegetables, fruits, whole grains and legumes when possible.
Many people can prevent hypertension, diabetes and other chronic ailments by taking these measures. Many others, though, develop the ailments despite working on these lifestyle methods. They should continue these healthy behaviours while also taking treatments as recommended by a health care provider. Doing so can prevent the long-term harm that could come from these conditions.
https://edition.cnn.com/2025/01/17/health/chronic-disease-hypertension-diabetes-wellness/index.html
