By: Colin Bullen

This is part 1 of The BRATLAB ‘Behavioral Prescription’ Series

High blood pressure, or “hypertension” has no immediately noticeable symptoms. It is therefore difficult to spot and often referred to as the “silent killer.” It is one of the most frequently diagnosed health conditions among US adults and was a primary or contributing cause of death for more than 410,000 Americans in 2014. That’s over 1,000 deaths each day and represents an 18% increase since 2009.

Hypertension is defined as blood pressure in excess of 140mmHg Systolic or 90mmHg Diastolic (“140 over 90”) and these levels are experienced by over 30% of the US population. The percentage of the population with hypertension increases significantly with age and is one of the leading indicators for chronic heart disease, heart attacks, stroke, aneurysms and aortic disease. The relationship between high blood pressure and risk of cardiovascular disease events is continuous, consistent, and independent of other risk factors — the higher the blood pressure, the greater is the chance of heart attack, stroke and kidney disease.

If you have a population impacted by hypertension, what behavior change would have the greatest impact on an individual’s risk profile? With a limited budget, where should you focus your resources?

The most effective wellness interventions for High Blood Pressure

Seniors laughing using hula hoops outdoorsThe Behavioural Research and Applied Technology Laboratory research suggests that behavior change can reduce hypertension significantly, and fast. Compared to other lifestyle habits, exercise has the largest impact. Research suggests that a reduction of around 55% in the prevalence of hypertension can be achieved through a ‘habit prescription’ or ‘dose’ of cardiovascular exercise at moderate (brisk walk) to intense (running) intensity levels for 30 minutes, five days per week. Although physicians recommend that exercise should still be combined with drug therapy, clinical trials confirm that exercise is at least as effective at controlling blood pressure as medicines — and with none of the unpleasant side effects.

In addition to exercise, getting adequate sleep (>7 hours per night) and meditation (transcendental, practiced twice a day for 20 minutes) significantly reduce hypertension prevalence by up to 40%. Other wellness interventions also show benefits, but not as large as these.

Making the Change: Adopting Healthy Behaviors that Reduce Hypertension

Organizations looking to change the health risk profile of their employee populations would do well to address hypertension, at least through exercise. Setting up a change-ready environment that allows employees to adopt healthier behaviors regarding exercise, meditation and sleep hygiene will result in significant improvements in an organization’s health risk profile.

Alongside the 30% of the population with hypertension, it’s estimated that around 60% of the US population does not exercise adequately. In the worst case this means that 18% of a typical US population will both hypertensive and not exercising adequately. However, given these findings, it’s likely that more than 60% of the hypertensive population are not exercising, meaning that 18% is an underestimate. Combining this finding with the 55% reduction available through exercise, suggests that a reduction of at least 10% in hypertension prevalence is achievable in a typical US population.

Within a few years, that will translate to significant reductions in cardiovascular and heart disease, more than reversing the increasing trend and reducing health plan costs. The cost and productivity benefits will manifest over time and can be accurately predicted.

Any organization looking to evaluate the impact of investing in these changes or wanting to understand more about how to create happy, healthy and change-ready cultures should contact Change Craft at hello@changecraft.consulting.


Colin BullenColin Bullen is the founder and director of Change Craft, a global business established to help organisations execute effective and successful well-being change. In business, he’s the technician, evaluator, and strategist. A true road-less-traveled devotee, he qualified as an actuary in 1992 in the UK before spending 13 years in South Africa where he met Chicago-based business partner Hanlie van Wyk. During this time, he has steadily broadened his métier into health, well-being, leadership, strategy, assessment, and data.

Colin has a deep passion for helping companies find their human touch, whilst accelerating their performance and focusing their vision. Colin is also one of the creators of the behavioural research database that is BRATLAB and has been a driving force behind early successes in Change Craft.