Nine out of 10 Will Develop High Blood Pressure, Study Says
By  Salynn Boyles

WebMD Medical News
 
 

Feb. 26, 2002 -- It has long been known that older people are at increased risk for high blood pressure, but new research finds that risk is even greater than has been suspected. Data from the ongoing Framingham Heart Study suggests that nine out of 10 Americans who are middle aged and older are likely to develop hypertension.

Researchers say the findings should serve as a wake-up call to older Americans who do not realize they are at increased risk, or who know they have high blood pressure, but take no steps to lower it. Uncontrolled hypertension can lead to stroke, heart disease, kidney failure, and other health problems.

"Our findings may help personalize the risk of high blood pressure," lead author Ramachandran S. Vasan, MD, tells WebMD. "There is a tendency to think of it as a problem for other people, but these figures tell us that everyone needs to be concerned as they age." Vasan is an associate professor of medicine at Boston University School of Medicine.

High blood pressure is defined in adults as a systolic pressure (top number) of 140 or higher and a diastolic level (bottom number) or 90 or more. Roughly 43 million Americans have high blood pressure, and millions more have readings that are considered to be in the high-normal range (systolic pressure between 130 and 139 and a diastolic pressure of 85 to 89).

In findings published late last year, Vasan and colleagues concluded that even people with borderline hypertension are at increased risk for heart attack, stroke, and heart failure. Their latest study, published in the Feb. 27 issue of The Journal of the American Medical Association, further confirms this.

The investigators determined the lifetime risk for developing hypertension in a group of 1,298 Framingham Heart Study participants. All were between the ages of 55 and 65 and did not have high blood pressure at entry. More than half of the 55-year-old participants and two-thirds of those who were 65 developed hypertension within 10 years of inclusion in the high blood pressure trial.

The lifetime risk of developing stage 2 or substantially elevated blood pressure (160/100 or more) was found to be lower among both men and women in the observation period between 1975 and 1998 than between 1952 and 1975. The authors attributed this reduction to more comprehensive use of drug treatments among people with very high, high blood pressure.

But the lifetime risk of developing moderate hypertension or worse was 90%  for both women and men -- far higher than had been anticipated. Vasan and colleagues conclude that people with moderately high blood pressure are being undertreated.

 "We have used the term mild hypertension in the past, but this is really a misnomer," says Edward Roccella, PhD, coordinator of the National Heart Lung and Blood Institute's (NHLBI) high blood pressure education program. "We now know that people who have levels approaching 140/90 better do something, because the damage could already be occurring. People with these borderline numbers are at increased risk, and they benefit from treatment."

The key to reducing blood pressure is making lifestyle changes, such as losing weight, exercising more, and eating better, Roccella says. Many people may also need medication, but findings from several widely publicized NHLBI-sponsored studies proved dietary changes alone can dramatically impact blood pressure levels. The Dietary Approaches to Stop
Hypertension (DASH) studies found that blood pressure was lowered significantly and quickly in patients eating low-fat diets high in fruits and vegetables and low in salt.

"Because this disease has no signs or symptoms, people tend to ignore it until they have a stroke or some other event," Roccella says. "We know that losing even moderate amounts of weight helps, and so does getting out there and moving, and lowering sodium intake. Nobody says it's easy, but these lifestyle changes do work."
 
 

Medically Reviewed
By Charlotte Grayson