Heart attack and stroke are two of the leading causes of death and disability worldwide. While a number of factors put us at risk, high blood pressure — or hypertension — is one of the most dangerous.

It is commonly referred to as a “silent killer” because rarely does the disorder cause any noticeable symptoms.

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In a study of 1,1000 volunteers at mobile clinics in Canada, researchers found that half the participants were unaware they had high blood pressure. Of those, two percent were at very high risk for health complications.

“Patients often stop taking their medication because they were able to get their blood pressure under control. But they miss the obvious reason their blood pressure was under control,” said one physician.

“A surprisingly large number of participants exhibited some type of hypertensive urgency or emergency,” study author Dr. Grant Pierce, executive director of research at St. Boniface Hospital in Winnipeg, said in a news release.

Yet these people weren’t being treated even if they had been diagnosed — either because they didn’t fully understand their condition or the health consequences associated with high blood pressure. That must change.

None of this comes as a surprise to John Flack, M.D., a hypertension specialist and chair of the Department of Medicine and Southern Illinois University. “Patients often stop taking their medication because they were able to get their blood pressure under control. But they miss the obvious reason their blood pressure was under control — because they were taking their medicine,” Flack told LifeZette. “Or they’ll say things like, ‘I’m not going to take more than two medications,’ and draw a line in the sand. Or they say, ‘I’m only going to take my medicine when I don’t feel well.'”

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Hypertension, he said, is probably the most studied, common medical condition physicians take care of, and there are many ways to treat it. “But there’s still a lot of fear, not only of hypertension but about the drugs we use to control blood pressure,” Flack told LifeZette.

Medications may do wonders for folks and save a lot of lives, but the most important thing any of the nearly 80 million adults in the U.S. with hypertension can do for themselves is eat better and get some exercise. Hypertension, or high blood pressure, is considered the most important modifiable risk factor in reducing the burden of stroke globally.

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“Adding fruit and vegetables and decreasing consumption of red meat, added sugar, salt, as well as adding moderate intensity exercise 45 minutes per day, can all but erase high blood pressure,” Dr. Scott Schreiber, a Newark, Delaware-based chiropractic physician certified in rehabilitation and clinical nutrition, told LifeZette.

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“Routine monitoring and taking steps to treat it are critical to preventing serious health conditions, like heart disease, heart attack and stroke,” he added.