Introduction: Its Time to End the Low-Fat Myth

Its time to end the low-fat myth. For decades, a low-fat diet was touted as a way to lose weight
and prevent or control heart disease and other chronic conditions, and food companies re-
engineered products to be reduced-fat or fat-free, often compensating for differences in flavor
and texture by increasing amounts of salt, sugar, or refined grains. However, as a nation,
following a low-fat diet hasnt helped us control weight or become healthier.
In the 1960s, fats and oils supplied Americans with about 45 percent of calories; (1)
about 13 percent of adults were obese and under 1 percent had type 2 diabetes, a serious
weight-related condition. (2,3)
Today, Americans take in less fat, getting about 33 percent of calories from fats and oils;
(4) yet 34 percent of adults are obese and 11 percent have diabetes, most with type 2
diabetes. (5,6)
Why hasnt cutting fat from the diet paid off as expected? Detailed research shows that the total
amount of fat in the diet isnt really linked with weight or disease. What really matters is the type
of fat and the total calories in the diet. (7-15)
Bad fats, meaning trans and saturated fats, increase the risk for certain diseases.
Good fats, meaning monounsaturated and polyunsaturated fats, do just the opposite. They
are good for the heart and most other parts of the body.
One problem with a generic lower fat diet is that it prompts most people to stop eating fats that
are good for the heart along with those that are bad for it. Another problem is that when people
cut back on fat, they often switch to foods full of easily digested carbohydrateswhite bread,
white rice, potatoes, sugary drinks, and the likeor to fat-free products that replace healthful
fats with sugar and refined carbohydrates. The body digests these carbohydrates very quickly,
causing blood sugar and insulin levels to spike. Over time, eating lots of fast carbs can raise
the risk of heart disease and diabetes as much asor more thaneating too much saturated fat.
(16-18) Thats why its important to replace foods high in bad fats with foods high in good
fatsnot with refined carbohydrates.
What about cholesterol in food? For most people, the mix of fats in the diet influences
cholesterol in the bloodstream far more than cholesterol in food does.
How Fat Moves from Food to the Bloodstream
Almost all foods contain some fat. Even quintessential fat-free foods like carrots and lettuce
contain small amounts of this nutrient. Thats a testament to how important fats are for life. Fat
provides a terrific source of energy as well as a great depot for storing it. It is an important part
of cell membranes, helping govern what gets into cells and what comes out. The body uses
cholesterol as the starting point to make estrogen, testosterone, vitamin D, and other vital
compounds. Fats are also biologically active molecules that can influence how muscles respond
to insulins open up for sugar signal; different types of fats can also fire up or cool down
inflammation.
Fat and cholesterol cant dissolve in water or blood. The body gets around this basic chemistry
problem by packaging fat and cholesterol into tiny, protein-covered particles called lipoproteins.
Although lipoproteins can carry quite a bit of fat, they mix easily with blood and flow with it.
Some of these particles are big and fluffy, others small and dense. The most important ones are
low-density lipoproteins, high-density lipoproteins, and triglycerides.
Low-density lipoproteins (LDL) carry cholesterol from the liver to the rest of the body. Cells
latch onto these particles and extract fat and cholesterol from them. When there is too much LDL
cholesterol in the blood, these particles can form deposits in the walls of the coronary arteries
and other arteries throughout the body. Such deposits, called plaque, can narrow arteries and
limit blood flow. When plaque breaks apart, it can cause a heart attack or stroke. Because of this,
LDL cholesterol is often referred to as bad, or harmful, cholesterol.
High-density lipoproteins (HDL) scavenge cholesterol from the bloodstream, from LDL, and
from artery walls and ferry it back to the liver for disposal. Think of HDL as the garbage trucks
of the bloodstream. HDL cholesterol is often referred to as good, or protective, cholesterol.
Several strategies can help you lower the amounts of total and harmful LDL cholesterol in your
bloodstream, and thus your risk of heart disease.
Triglycerides make up most of the fat that you eat and that travels through the bloodstream. As
the bodys main vehicle for transporting fats to cells, triglycerides are important for good health.
But as is the case for so many things, an excess of triglycerides can be unhealthy.
In general, the lower your LDL and the higher your HDL, the better your chances of preventing
heart disease and other chronic conditions. Guidelines from the National Cholesterol Education
Program suggest specific targets.
How Fat and Cholesterol in Food Affect Blood Cholesterol Levels
The types of fat in the diet determine to a large extent the amount of total, HDL, and LDL
cholesterol in the bloodstream. The types and amount of carbohydrate in the diet also play a role.
Cholesterol in food matters, too, but not nearly as much.
Good Fats
Unsaturated fats are called good fats because they can improve blood
cholesterol levels, ease inflammation, stabilize heart rhythms, and play a number of other
beneficial roles. Unsaturated fats are predominantly found in foods from plants, such as
vegetable oils, nuts, and seeds. They are liquids at room temperature.
There are two types of unsaturated fats:
Monounsaturated fats are found in high concentrations in olive, peanut, and canola oils;
avocados; nuts such as almonds, hazelnuts, and pecans; and seeds such as pumpkin and
sesame seeds.
Polyunsaturated fats are found in high concentrations in sunflower, corn, soybean, and
flaxseed oils, and also in foods such as walnuts, flax seeds, and fish; canola oil, though
higher in monounsaturated fat, is also a good source of polyunsaturated fat. Omega-3
fats, which are fast becoming the darling of the supplement industry, are an important
type of polyunsaturated fat. The body cant make these, so they must come from food. An
excellent way to get omega-3 fats is by eating fish two or three times a week. Good plant
sources of omega-3 fats include chia seeds (sold as Salvia), flax seeds, walnuts, and oils
such as flaxseed, canola, and soybean.
Dutch researchers conducted an analysis of 60 trials that examined the effects of carbohydrates
and various fats on blood lipid levels. In trials in which polyunsaturated and monounsaturated
fats were eaten in place of carbohydrates, these good fats decreased levels of harmful LDL and
increased protective HDL. (19) More recently, a randomized trial known as the Optimal
Macronutrient Intake Trial for Heart Health (OmniHeart) showed that replacing a carbohydrate-
rich diet with one rich in unsaturated fat, predominantly monounsaturated fats, lowers blood
pressure, improves lipid levels, and reduces the estimated cardiovascular risk. (7)
Most people dont get enough of these healthful unsaturated fats each day. No strict guidelines
have been published regarding their intake. The traditional Greek diet, for example, gets up to 30
percent of its calories from monounsaturated fats, mostly from olive oil. For polyunsaturated
fats, the American Heart Association has set 8 to 10 percent of calories as a prudent target; there
is evidence, though, that eating more polyunsaturated faton the order of 15 percent of daily
caloriesin place of saturated fat can lower heart disease risk. (13) Since no one eats by
percentage of daily calories, a good rule of thumb is to choose foods rich in unsaturated fats over
foods rich in saturated fats whenever possible. (To learn more, check out this chart, Finding
Foods with Healthy Fats.)
Bad Fats
Theres been controversy brewing over the past decade about just how bad saturated fat is for
health. Fueling the debate, in part, has been the resurgence of the Atkins Diet, which eschews
carbs but allows liberal use of high-fat foods, including foods high in saturated fatbutter,
bacon, steak, cheese, and the like. (20) More recently, several studies seemed to suggest that
eating diets high in saturated fat did not raise the risk of heart diseasea finding that ran counter
to decades of dietary advice. (21,22) One highly-publicized report analyzed the findings of 21
studies that followed 350,000 people for up to 23 years. Investigators looked at the relationship
between saturated fat intake and coronary heart disease (CHD), stroke, and cardiovascular
disease (CVD). Their controversial conclusion: There is insufficient evidence from prospective
epidemiologic studies to conclude that dietary saturated fat is associated with an increased risk of
CHD, stroke, or CVD.(21)
With headlines like Saturated Fat is Not Your Hearts Enemy, and NOT GUILTY: The Long-
Standing Vilification of Saturated Fat Finally Turning to Vindication,(23,24) some of the media
and blog coverage of these studies would have you believe that scientists had given a green light
to eating bacon, butter, and cheese. But thats an oversimplified and erroneous interpretation.
Read the study and subsequent studies more closely, and the message is more nuanced: Cutting
back on saturated fat can be good for health if people replace saturated fat with good fats,
especially, polyunsaturated fats. (16,25) Eating good fats in place of saturated fat lowers the
bad LDL cholesterol, and it improves the ratio of total cholesterol to good HDL cholesterol,
lowering the risk of heart disease. Eating good fats in place of saturated fat can also help prevent
insulin resistance, a precursor to diabetes. (26)
Cutting back on saturated fat will likely have no benefit, however, if people replace saturated fat
with refined carbohydrateswhite bread, white rice, mashed potatoes, sugary drinks, and the
like. Eating refined carbs in place of saturated fat does lower bad LDL cholesterolbut it also
lowers the good HDL cholesterol and increases triglycerides. The net effect is as bad for the
heart as eating too much saturated fatand perhaps even worse for people who have insulin
resistance because they are overweight or inactive. (17,25)
The latest Dietary Guidelines for Americans recommends getting less than 10 percent of calories
each day from saturated fat. (27) The American Heart Association goes even further,
recommending limiting saturated fat to no more than 7 percent of calories. (28) But framing diet
recommendations in terms of percentage of daily calories is not terribly useful for the average
consumer. Thats because people eat foodsnot isolated nutrients.
In the U.S., pizza and cheese are the biggest food sources of saturated fat in the diet (see table).
(29) Other dairy products (whole and reduced fat milk, butter, dairy desserts) and meat products
(sausage, bacon, beef, hamburgers) are also major contributors, as are foods made with them
(cookies and other grain-based desserts, Mexican dishes). Keep in mind that all foods contain a
mix of fats: Even healthy foods like chicken and nuts do contribute some saturated fat to the
diet, though they are much lower in saturated fat than beef, cheese, and ice cream. A few plant
foods are also high in saturated fats, such as coconut and coconut oil, palm oil, and palm kernel
oil.
As a general rule, its a good idea to keep your intake of saturated fats as low as possible. We
cant eliminate saturated fat from our diets completely, because foods that are good sources of
healthy fatsolive oil, walnuts, salmonalso contain a little bit of saturated fat. And it would
be a mistake to cut back on nuts, oils, and fish to minimize saturated fat. When you add it up, red
meat and full-fat dairy products (cheese, milk, ice cream, butter) are among the main sources of
saturated fat in our diets. So keeping these foods low is the best way to reduce intake of saturated
fat. And when you cut back on red meat and dairy products, replace them with foods that contain
healthy fatsfatty fish like salmon, nuts and seeds, plant oils, avocadoesnot with foods that
are high in refined carbohydrates.
Very Bad Fats: Trans Fats
Trans fatty acids, more commonly called trans fats, are made by heating
liquid vegetable oils in the presence of hydrogen gas and a catalyst, a process called
hydrogenation. Partially hydrogenating vegetable oils makes them more stable and less likely to
spoil. It also converts the oil into a solid, which makes transportation easier. Partially
hydrogenated oils can also withstand repeated heating without breaking down, making them
ideal for frying fast foods. (Fully hydrogenating a vegetable oil creates a fat that acts like a
saturated fat.) Its no wonder that partially hydrogenated oils became a mainstay in restaurants
and the food industry, for frying, baked goods, and processed snack foods and margarines.
For years, margarine was promoted as a heart-healthy alternative to butter. Since margarine was
made from unsaturated vegetable oils, most people assumed it would be better for long-term
health than butter, which was known to contain a lot of cholesterol and saturated fat. That
assumption turned out to be wrong. Research showed that some forms of margarine
specifically the hard stick margarineswere worse for the heart than butter. This was because
they contained large amounts of trans fats from partially hydrogenated oils.
The Nurses Health Study found that women who ate 4 teaspoons of stick margarine a day had a
50 percent greater risk of heart disease than women who ate margarine only rarely. (62)
So should you choose butter over margarine? Whenever possible, skip both and use a liquid
vegetable oil. At the table, try dipping bread in olive oil instead of slathering it with butter or
margarine. When sauting, try using olive, canola, or another liquid vegetable oil, with a little bit
of butter for flavor. If you need something spreadable, choose a soft margarine that is not only
trans free but low in saturated fat. A number of soft margarines are made from a blend of
healthful oils, and some have the added benefit of containing cholesterol-lowering plant sterols.
Keep in mind that you need to eat two servings of these sterol-containing margarines a day to put
a small dent in your LDL level. Read more about how to spot trans fat on food labels.
Partially hydrogenated oil is not the only source of trans fats in our diets. Trans fats are also
naturally found in beef fat and dairy fat, in small amounts.
Trans fats are worse for cholesterol levels than saturated fats because they raise bad LDL and
lower good HDL. They also fire inflammation, (30) an overactivity of the immune system that
has been implicated in heart disease, stroke, diabetes, and other chronic conditions. And they
contribute to insulin resistance. (26) Even small amounts of trans fat in the diet can have harmful
health effects. For every extra 2 percent of calories from trans fat daily, the risk of coronary heart
disease increases by 23 percent. Eliminating industrial-produced trans fats from the U.S. food
supply could prevent between 6 and 19 percent of heart attacks and related deaths, or more than
200,000 each year. (31)
In the 1990s, the average American was eating about six grams of trans fats a day, most of that
from partially hydrogenated oils found in commercially prepared baked goods, margarines,
snack foods, processed foods, French fries, and other fried foods prepared in restaurants and fast
food franchises. (32) Ideally that should be under two grams a day, and zero from partially
hydrogenated oils is best.
A 2006 labeling law that forced food companies to list trans fats on the label has reduced trans
fat levels in the U.S. food supply, since many food makers have switched to using trans-free oils
and fats in their products. And recent study from the Centers for Disease Control and Prevention
finds that Americans blood-levels of trans fats dropped 58 percent from 2000 to 2009
evidence that the labeling law has had its desired effect. (64) Some experts had feared that food
makers would replace trans fat with saturated fat, diminishing any health benefits from the
switch. But 2010 survey of 83 major-brand grocery store products and restaurant dishes offers
encouraging news: When most of these food makers reformulated their products, they cut back
on trans fat without increasing saturated fat. (33)
As trans fat intake dwindles in developed countries, it is on the rise in some developing nations.
Inexpensive partially hydrogenated soybean oil has become a staple not only for the food
industry but for home use. This shift away from traditional cooking oils and toward trans-rich
partially hydrogenated oils is contributing to the growing epidemic of cardiovascular disease in
developing nations around the world.
Cholesterol in Food
The discovery half a century ago that high blood cholesterol levels were
strongly associated with an increased risk for heart disease triggered numerous warnings to avoid
foods that contain cholesterol, especially eggs and liver. As it turns out, most people make more
cholesterol than they absorb from their food. A body of scientific studies shows only a weak
relationship between the amount of cholesterol a person consumes and his or her blood
cholesterol levels (34) (weak but still important for heart disease). In studies of more than 80,000
female nurses, Harvard researchers found that consuming about an egg a day was not associated
with higher risk of heart disease (too few women in the study were eating more than an egg a day
to evaluate the effects of higher egg intakes). (35,36) One reason for the lack of association is
that eggs are a good source of many nutrients that may counterbalance a slight increase in risk of
heart disease. Also, eggs can take the place of other breakfast foods that have adverse effects,
such as white toast with butter. One note of caution: Among women in this study with diabetes
and in another study of men with diabetes, higher egg consumption has been associated with
increased risks of heart disease.
Research suggests that moderate egg consumption can be part of a healthy diet. But this research
doesnt give the green light to daily three-egg omelets, especially for people who already have
heart disease or diabetes. Read more about eggs and heart health.
For most people, the amount of cholesterol eaten has only a modest impact on the amount of
cholesterol circulating in the blood. (37) For some people, though, blood cholesterol levels rise
and fall very strongly in relation to the amount of cholesterol eaten. For these responders,
avoiding cholesterol-rich foods can have a substantial effect on blood cholesterol levels.
Unfortunately, at this point there is no way other than by trial and error to identify responders
from non-responders to dietary cholesterol.
Dietary Fats and Heart Disease: Healthy Fats in Healthy Diets, Not Low Fat
For years, the party line from the American Heart Association, National
Institutes of Health, World Health Organization, and others was to reduce dietary fat. They
generally called for limiting fat intake to under 30 percent of daily calories. There wasnt much
evidence to support the notion of low-fat diets in the beginning. (38) There is even less now.
Numerous reports over the years have questioned the wisdom of recommending low-fat diets for
preventing or retarding heart disease.
A big nail in the coffin came from the Womens Health Initiative Dietary Modification Trial,
published in the February 8, 2006, Journal of the American Medical Association. (9) This eight-
year trial, which included almost 49,000 women, found virtually identical rates of heart attack,
stroke, and other forms of cardiovascular disease in women who followed a low-fat diet and in
those women who didnt. Whats more, women on the low-fat diet didnt loseor gainany
more weight than women who followed their usual diets. (8)
This randomized trial supports prior findings from the Nurses Health Study (36) and the Health
Professionals Follow-up Study. (39) In both of these, no link was seen between the overall
percentage of calories from fat and any important health outcome, including cancer, heart
disease, and weight gain. What was important in these studies was the type of fat in the diet. (40)
As research grows on diet and heart disease, its becoming clearer that looking at a single
nutrient in isolation cannot tell us the whole story about a persons heart disease risk. People eat
foods, not nutrients, and they eat them in an overall dietary pattern. The so-called Western diet
patternhigh in red meat and processed meat, refined grains, potatoes, and sugary drinks, and
low in fruits, vegetables, whole grains, and healthy fatsis associated with higher risk of heart
disease. The traditional Mediterranean Diet pattern, in contrast, appears to lower the risk of heart
disease, stroke, and metabolic syndrome, a constellation of factors that increases the chances of
developing heart disease and diabetes. (11,41,42)
The Mediterranean-style diet is high in fat, but most of that fat comes from olive oil or plant
sources, such as nuts and seeds, and saturated fat intakes are low. Mediterranean-style diets are
also characterized by bountiful intakes of vegetables, fruits, beans, nuts, and whole grains, as
well as some cheese and yogurt. So if you are concerned about heart health, pay attention to your
overall diet, not just to the type of fat. (Check out two clear guides to choosing a healthy diet,
from the Dept. of Nutrition at Harvard School of Public Health: the Healthy Eating Pyramid and
the Healthy Eating Plate.)
Dietary Fats and Diabetes
The types of fats in your diet can also affect the development of diabetes. Good fats, such as the
polyunsaturated fats found in liquid vegetable oils, nuts, and seeds can help ward off type 2
diabetes. (26) Trans fats do just the opposite. (31,40) Eating omega-3 fats from fish does not
protect against diabetes, even though there is much evidence that these marine omega-3 fats help
prevent heart disease. (43) If you already have diabetes, eating fish can help protect you against a
heart attack or dying from heart disease. (44)
High Blood Pressure
High blood pressure occurs when the pressure within blood vessels is too high.
People with an average blood pressure reading of more than 140/90 are
considered to have high blood pressure. If it goes untreated or uncontrolled, the
condition can lead to serious health problems, such as heart attack and kidney
failure. Common risk factors include obesity, being physically inactive, and
consuming too much sodium.
Introduction to High Blood Pressure
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An Introduction to High Blood Pressure
Blood pressure is a measure of the pressure inside your blood vessels -- both while the heart is
beating and while it is relaxed. High blood pressure, as you might guess, is when the pressure
within your blood vessels is too high. This is also known as hypertension.
bout 65 million American adults -- nearly 1 in 3 -- have high blood pressure.

Why Is Blood Pressure Important?
Blood pressure is the amount of force (pressure) that blood exerts on the walls of the vessels as it
passes through them. As blood is pumped from your heart into your blood vessels, enough
pressure is created to send it to all other parts of your body. As vessels travel away from the
heart, they branch off and gradually get smaller, just like the branches of a tree. One branch may
go to the brain, while another may go to your kidneys. Blood pressure keeps the blood flowing
through all these branches so that your body's cells get the oxygen and nutrients they need and
waste matter can be removed.

Causes of High Blood Pressure
In most people, the specific cause or causes of high blood pressure are not known. This is called
primary or essential hypertension. In other people, the condition is the result of another medical
problem or medication. When the cause is known, this is called secondary high blood pressure or
secondary hypertension.

If a person is diagnosed with high blood pressure, it doesn't mean that he or she is "too nervous,"
overanxious, or obsessive. This is a popular myth. High blood pressure is not nervous tension. In
fact, many people who are perfectly calm have the condition.
Risk Factors for High Blood Pressure
While for most people there is no known cause of high blood pressure, there are factors that can
increase a person's chance of developing it. Some of these risk factors cannot be controlled,
including:

Being African American
Being a male over the age of 45 or a female over the age of 55
Having a family history of the condition.

However, some risk factors can be controlled, including:

Being overweight or obese
Being physically inactive
High salt (sodium) intake
Low potassium intake (due to not eating enough fruits and vegetables)
Excessive alcohol consumption
Having diabetes
Having prehypertension (that is, blood pressure in the 120-139/80-89 mmHg range).

Symptoms of High Blood Pressure
Most people with high blood pressure don't have any symptoms. This is because the condition
doesn't cause problems over a day or weeks, or even months. It usually takes several years for
high blood pressure to cause noticeable symptoms, and even when it does cause problems, the
symptoms are often mild and nonspecific (meaning they could be caused by several different
conditions). For this reason, high blood pressure is often referred to as "the silent killer." People
with the condition typically don't even realize they have it until they have blood pressure
readings that are too high.

(Click High Blood Pressure Symptoms for more information.)

Testing for High Blood Pressure
Having a blood pressure test is quick and painless. It involves using either a sphygmomanometer
or blood pressure machine to measure the blood pressure. Blood pressure is measured in
millimeters of mercury (mmHg) and recorded as two numbers: systolic pressure "over" diastolic
pressure. For example, the doctor or nurse might say "130 over 80" as a blood pressure reading.
This is written as 130/80. Many people define normal blood pressure as an average reading of
120/80 or below.

Both numbers in a blood pressure reading are important. As we grow older, systolic blood
pressure is especially important.
Diagnosing High Blood Pressure
High blood pressure can only be diagnosed after taking several readings to find your average
blood pressure. To determine your average blood pressure, your blood pressure needs to be taken
two or more times, and each reading must be from a different day. If the average of these
readings is more than 140/90, you have high blood pressure.

A single reading that is more than 140/90 doesn't necessarily mean that you have high blood
pressure; however, your healthcare provider will probably want to monitor your blood pressure
over time to see if it stays there. You can also have high blood pressure if the average of only
one of the numbers (systolic or diastolic) is too high.

Effects of High Blood Pressure
The body structures that chronic (long-term) high blood pressure affects most include the:

Blood vessels
Heart
Brain
Kidneys
Eyes.

Because of the effects of high blood pressure on these vital organs, a person who has had it for a
long time (known as chronic hypertension) can have:

A heart attack
Congestive heart failure (CHF)
A stroke or "mini stroke" -- also known as a "TIA" (transient ischemic attack)
Eye damage with loss of vision
Kidney failure
Peripheral arterial disease, including bulges or outpouchings of the aorta (called
aneurysms).

Treating High Blood Pressure
Hypertension research scientists have found certain lifestyle changes that can lower blood
pressure. If lifestyle changes alone cannot lower blood pressure to a "normal" level, blood
pressure medication can be prescribed.

Lifestyle changes are the first form of high blood pressure treatment. They usually help improve
a person's quality of life as well. It may take three to six months before your healthcare provider
sees the full benefit of lifestyle changes in your condition. Some of these changes may include:

Weight loss (see Weight and High Blood Pressure)
Exercise (see Exercise and High Blood Pressure)
Cutting down the salt in your diet (see Salt and High Blood Pressure)
Following a diet that emphasizes fruits and vegetables while reducing fats and cholesterol
(see High Blood Pressure Diet)
Drinking less alcohol (see Alcohol and High Blood Pressure).

Other lifestyle factors that may influence blood pressure and that should be reduced or stopped
completely include smoking and prolonged stress (see Smoking and High Blood Pressure or
Stress and High Blood Pressure).

By lowering blood pressure, people can reduce the long-term effects of hypertension, including
heart attacks, stroke, and kidney failure.
ypes of High Blood Pressure
There are a number of different categories of high blood pressure. Most people have what is
known as essential hypertension or primary hypertension. This is high blood pressure where the
cause is not known. Other types include:

Isolated systolic hypertension
White-coat hypertension
Malignant hypertension
Portal hypertension
Pulmonary hypertension
Secondary hypertension
Intracranial hypertension
Prehypertension.

There are several types of high blood pressure in pregnancy. These types include:

Preeclampsia (also known as pregnancy-induced hypertension, toxemia of pregnancy, or
acute hypertensive disease of pregnancy)
Eclampsia
Chronic hypertension
Chronic hypertension with preeclampsia
Late hypertension (also called gestational hypertension).

High Blood Pressure: Looking Ahead
Many people do not have symptoms of high blood pressure or discomfort, so they find it easy to
ignore their condition. However, this significantly increases the chances of having:

Kidney disease
Heart attack
Stroke
Other heart and blood vessel problems.

Getting the condition under control may add years to a person's life. Healthy lifestyle changes
often improve both a person's high blood pressure and his or her quality of life.