High Blood Pressure


What is High Blood Pressure?

High blood pressure, or hypertension, is defined as a consistently elevated level of diastolic (the lowest pressure in the bloodstream between heart beats) and systolic (the highest pressure in the bloodstream during each heart beat) blood pressure in the arteries. It is sometimes referred to as arterial hypertension, and is considered a chronic medical condition when normal blood pressure has been exceeded.

Blood pressure in a normal range is considered between 100 – 140 mmHg for the top reading (systolic) and 60 – 90 mmHg for the bottom reading (diastolic). A reading of over 140/90 mmHg qualifies as high blood pressure.

Those who have hypertension are at risk for a variety of serious medical conditions, such as heart attacks, stroke, aortic aneurysms, heart failure, and a decrease in life expectancy. It can also lead to problems such as kidney failure and blindness depending on where the hypertension manifests. Treating high blood pressure takes considerable changes to diet and lifestyle, many times requiring medication when implementing proper diet and exercise is insufficient.

3 Stages of Blood Pressure Readings:

  1. Pre-Hypertension is considered when the top reading (systolic) is between 120 – 140 mmHg, or the bottom reading (diastolic) is between 80 – 90 mmHg.
  2. Stage 1 Hypertension is considered when systolic blood pressure is between 139 – 160 mmHg, or diastolic blood pressure is between 89 – 100 mmHg.
  3. Stage 2 Hypertension is considered when a systolic reading is above 159 mmHg, and the diastolic reading is above 99 mmHg.

 

Potential Causes of Hypertension

While the ultimate cause of high blood pressure is not known, there are various factors that have been proven to place certain individuals at risk. Below is a list of possible reasons a person’s blood pressure is likely to be above normal:

  • Stress
  • Obesity
  • Inactive lifestyle
  • Tobacco use
  • Family history
  • Race
  • Aging
  • Consuming a high amount of sodium or saturated fat
  • Contraceptives containing hormones
  • Consuming an excess amount of alcohol


 

Underwriting for Individuals with Hypertension

Insurers are unable to consider your high blood pressure and other health problems when applying for coverage. Refer to the information below to compare pre-health reform insurer freedoms to post-health reform patient freedoms.

 

When underwriting for health insurance, several key concerns arise with hypertension. There is a series of questions that must be asked in order to decide on the level of risk for each individual. The following should be asked of the applicant to ensure there is no information left out, and the underwriting process is completed accurately.

  • Is the individual a smoker?

If so, and he or she also has high blood pressure, the chances of being eligible for insurance are slim. Regular smoking and tobacco use worsens the symptoms of hypertension, and therefore should be stopped before applying for health insurance to increase the chances of being insurable.

  •  What medications do they presently take?

For those with hypertension, the process of medicated treatment begins with one medication, then another is added if not successful if the first prescription alone has not significantly decreased blood pressure. As the number of medications for hypertension treatment increases, so does the applicant’s risk of life-threatening illness or complications. This is important to consider, as it may cause an individual to be ineligible for insurance due to their high risk.

  • When was their hypertension diagnosed?

If the applicant has not made necessary efforts to treat their condition since diagnosis, the higher their risk of a life-threatening illness. Finding out when the individual was diagnosed will help determine their risk level. If they have had the condition for multiple years, the applicant’s doctor must give the underwriter a report of their blood pressure for the past three visits as regulated. This documentation could impact the applicant’s approval and also the cost of insurance.

  • Have they experienced any health problems as a result of hypertension (such as kidney failure, stroke, heart disease, heart attack)?

The health complications that result from hypertension are many, and it is considered a form of heart disease. Health problems that are usually caused by hypertension are coronary angioplasty, angina, heart attack, heart failure, stroke, TIA (or mini-stroke), or the need for coronary artery bypass surgery. When underwriting for someone with hypertension, it is essential to get the full details of their medical history.

  • Have they made any changes to their lifestyle?

If an applicant with high blood pressure has put forth effort to decrease their blood pressure through lifestyle changes, this can effect their insurability. Committing to exercise, a health diet, weight loss, quitting smoking, and limiting alcohol consumption are proven effective ways to regulate blood pressure. The applicant may be asked to provide documentation of the efforts they have made, through a dietician, nutritionist, clinician, or other professional to positively effect their future insurance policy.

  • Have they done any type of cardiac testing?

The risk of heart disease is an insurer’s highest concern for those with hypertension. Applicants who have tested their heart rate on a treadmill or other cardio machine with a positive outcome can be eligible for more reasonable insurance costs. Again, documentation must be provided to prove these results by a physician or other qualified professional.

 

 

Sources:

1. Carretero OA, Oparil S (January 2000). “Essential hypertension. Part I: definition and etiology”

2. stopquitsmoking.info. “High Blood Pressure and Health Insurance”