U.S. middle-aged at risk for hypertension

May 1, 2002

Pharmaceutical Representative

Pharmaceutical Representative-05-01-2002,

Middle-aged Americans face a 90% chance of developing high blood pressure at some time during the rest of their lives, according to a new study.

Middle-aged Americans face a 90% chance of developing high blood pressure at some time during the rest of their lives, according to a new study supported by the National Heart, Lung and Blood Institute.

However, the study also found that the risk of developing severe degrees of high blood pressure has decreased in the past 25 years, due partly to improved treatment.

The study, based on data from the NHLBI's Framingham Heart Study, appears in the Journal of the American Medical Association (vol. 287, no. 8).

"Americans have to better understand their risk of developing high blood pressure," said NHLBI Director Claude Lenfant. "They cannot adopt a wait-and-see approach. If they do, chances are they will find themselves with high blood pressure, and that puts them at increased risk for heart disease and stroke."

Framingham Heart Study

The Framingham Heart Study began in 1948 with 5,209 participants who were aged 28 to 62 and were without cardiovascular disease. Participants underwent medical examinations every two years.

The current study includes 1,298 of the original participants - those who had not developed hypertension by 1975. Researchers calculated lifetime risk for two ages: 55 and 65.

The investigators found that the lifetime risk of developing hypertension was about 90% for men and women at both ages. Further, more than half of the participants aged 55 and about two-thirds of those aged 65 went on to develop hypertension within 10 years. Both men and women had a nearly 60% chance of being prescribed blood pressure-lowering drugs.

Other study results include:


•Â Nearly 85% of the participants developed Stage I or greater hypertension over 20 to 25 years. Thirty-five percent to 44% of them went on to develop Stage II or greater hypertension.


•Â For women, there were no differences in lifetime risk between the earlier and later time periods. By contrast, men had a higher lifetime risk of developing hypertension during the later time period.


•Â Both men and women had a greater lifetime risk of receiving a hypertension medication in the later time period.


•Â The risk of developing Stage II or greater hypertension (160/100 mm Hg or higher) decreased for both men and women in the more recent time period.

"The trends over time may be due in part to an increase in obesity among the men in the study," said Ramachandran Vasan, associate professor of medicine at Boston University School of Medicine and a coauthor of the study. "Their average body mass index rose between the two periods. Women in the study did not have such a rise in body mass index."

He added, "The decrease in the lifetime risk of developing Stage II or greater hypertension for both men and women probably resulted from an increased use of hypertension-lowering drugs through the years."

Vasan cautions that the study was not ethnically diverse and stresses that the lifetime risk of developing hypertension varies among individuals and depends on the presence of risk factors.

"Americans should see their doctor and have their blood pressure checked," Vasan said. "They can talk about their risk factors and the steps they can take to reduce their risk of hypertension. Americans don't necessarily have to develop high blood pressure as they get older. What they have to do is take preventive action." PR

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