High blood pressure, or hypertension, affects nearly half (48.1%) of all adults in the U.S. Yet despite this prevalence, around one-third do not know they have it, and are therefore not being treated (with or without medication). What’s more, most of the time high blood pressure presents no obvious symptoms that indicate something is wrong. For this reason, it has been dubbed “the silent killer.” 

Uncontrolled high blood pressure can damage the arteries and make them less elastic. This decreases the flow of blood and oxygen to the heart and leads to heart disease, which is the leading cause of death for men, women, and people of most racial and ethnic groups in the U.S. In 2021, about 695,000 people in the U.S. died from heart disease. 

Heart disease also takes a massive financial toll in the U.S., with an annual cost of around $240 billion. And relatively soon this dizzying sum might actually seem like a bargain: a study commissioned by the American Heart Association projects that by 2035, the number of Americans with cardiovascular disease will rise to 131.2 million — or 45% of the total U.S. population — with annual costs expected to reach a whopping $1.1 trillion. 

Naturally, employers are shouldering much of this financial burden. An infographic [PDF] by the American Heart Association highlights that: 

  • High blood pressure raises an employee’s healthcare costs by nearly one-third.
  • High blood pressure-related absenteeism costs employers $10.3 billion per year.
  • Employees with heart disease work 56 hours less a year, and cost $1,119 more per year in insurance. 
  • Congestive heart failure costs all payers $8,332 a person per year.
  • Stroke (which can be caused by high blood pressure) costs all payers $6,492 a person per year.

After seeing their healthcare costs rise 5% in 2022, 54% of U.S. employers expect them to climb 6% in 2023, and 71% anticipate moderate to significant increases over the next three years as contracts come up for renewal, and new pricing takes into account multiple years of pent-up inflation. 

The good news is that the risks and costs would fall if more people visited their doctor on a regular basis to (among other things) check their blood pressure, and confirm that things are trending in the right direction — or make some changes if they are not. But the bad news is that only an estimated 8% of Americans undergo routine preventative screenings. 

And so, the priority for employers should be to actively encourage their employees to check their blood pressure on a regular basis so they can get ahead of the curve, and use what they learn not just to improve or preserve their health, but possibly to save their life. Here are three core ways for Benefit Directors and other HR leaders to help make this happen:

1.       Provide educational resources from credible sources. 

Create or refer to resources such as links to articles, videos, and infographics from credible sources (e.g., American Heart Association, CDC, American Medical Association, Health.gov, etc.) that help employees grasp the importance of regularly checking their blood pressure — even if they have no symptoms, currently lead a healthy lifestyle, or have no family history of high blood pressure or heart disease. 

For example, the American Heart Association published an eye-opening article about a 55-year-old California man who suffered a stroke after unknowingly living with “a ticking time bomb” (high blood pressure) for over a decade. The idea is not to terrify or overwhelm employees, as that can contribute to health information fatigue. Rather, the goal is to help employees understand the value, wisdom — and frankly, the self-interest — of keeping an eye on their blood pressure.   

2.       Run On-Site Blood Pressure Screening Clinics  

Partner with local health practices or organizations to run on-site blood pressure screening clinics. One of the biggest reasons that people avoid seeing their doctor is that they are too busy. In addition, a survey found that the most stressful part of a doctor’s office is the wait. On-site screening is convenient, and does not require taking time off work. 

3.       Provide heart health-focused digital therapeutics as a benefit offering 

Digital therapeutics make self-screening of blood pressure fast, reliable, and fun. Employees simply wrap a cuff around their upper arm (a familiar experience repeated many times at the doctor’s office or hospital), relax for a couple of minutes, and then use their smartphone to take a blood pressure reading. The results are available instantly in an easy-to-understand screen. A letter to the editor published in EXCLI Journal states: “Self-screening of blood pressure could be an effective and practical intervention to this public health concern [of high blood pressure and heart disease]. It should be widely practiced, as it would aid the timely identification of hypertension.” 

Some digital therapeutics also use an AI and ML-driven engine to deliver peer-reviewed, personalized advice and encouragement to boost heart health. Employees can also import their cholesterol numbers to get a more complete picture of their heart health and overall wellness.  

The Final Word 

The biological mechanisms that govern blood pressure are truly fascinating. But the potential consequences of high blood pressure are anything but amazing — they are alarming. Encouraging and enabling your employees to regularly monitor their blood pressure can go a long way towards supporting their overall health and wellness, and at the same time, helping your organization reduce ever-increasing direct and indirect healthcare costs. Now that is a win-win outcome that everyone can “take to heart” —  figuratively and in this case, literally!


Hello Heart is not a substitute for professional medical advice, diagnosis, and treatment. You should always consult with your doctor about your individual care.

1. Gazit T, Gutman M, Beatty AL. Assessment of Hypertension Control Among Adults Participating in a Mobile Technology Blood Pressure Self-management Program. JAMA Netw Open. 2021;4(10):e2127008, https://doi.org/10.1001/jamanetworkopen.2021.27008. Accessed October 19, 2022. (Some study authors are employed by Hello Heart. Because of the observational nature of the study, causal conclusions cannot be made. See additional important study limitations in the publication. This study showed that 108 participants with baseline blood pressure over 140/90 who had been enrolled in the program for 3 years and had application activity during weeks 148-163 were able to reduce their blood pressure by 21 mmHg using the Hello Heart program.) (2) Livongo Health, Inc. Form S-1 Registration Statement. https:/www.sec.gov/Archives/edgar/data/1639225/000119312519185159/d731249ds1.htm. Published June 28, 2019. Accessed October 19, 2022. (In a pilot study that lasted six weeks, individuals starting with a blood pressure of greater than 140/90 mmHg, on average, had a 10 mmHG reduction.) NOTE: This comparison is not based on a head-to-head study, and the difference in results may be due in part to different study protocols.
2. Validation Institute. 2021 Validation Report (Valid Through October 2022). https://validationinstitute.com/wp-content/uploads/2021/10/Hello_Heart-Savings-2021- Final.pdf. Published October 2021. Accessed October 19, 2022. (This analysis was commissioned by Hello Heart, which provided a summary report of self-fundedemployer client medical claims data for 203 Hello Heart users and 200 non-users from 2017-2020. Findings have not been subjected to peer review.)