Death Rates Among People With High Blood Pressure
MONDAY, April 25 (HealthDay News) -- Although the death rate
among Americans with high blood pressure, or hypertension, has
fallen since the 1970s, it still far exceeds the death rate for
those with normal blood pressure, new research finds.
U.S. researchers looked at data on about 23,000 adults aged 25
to 74 from two national health surveys: the National Health and
Nutrition Examination Survey (NHANES) I, which recruited
participants between 1971 and 1975; and NHANES III, which enrolled
adults between 1988 and 1994.
Death rates among those with high blood pressure fell between
the two time periods, from 18.8 per 1,000 person-years to 14.3 per
1,000 person-years. But the death rate for people with hypertension
was 42 percent higher than for those without hypertension in the
earlier period and 57 percent higher than for those with healthy
blood pressure in the later survey.
The study is published in the April 26 issue of
"The whole population has been benefiting from longer life expectancy," said Dr. Earl Ford, study author and medical officer with the U.S. Public Health Service at the Centers for Disease Control and Prevention. "The drop was greater among people without hypertension than for those with hypertension."
Researchers are concerned that while death rates improved for
the general population, people with high blood pressure benefited
less than the rest of the population.
For example, death rates for diseases of the circulatory system
fell about 46 percent for those without hypertension but only 37
percent for those with hypertension. Stroke deaths dropped 51
percent for those without hypertension and just 39 percent for
those with hypertension, while deaths from heart disease declined
46 percent for those without hypertension and 35 percent for those
Though men with hypertension were more likely to die than women
with hypertension in both time periods, men's reduction in blood
pressure was more than four times greater than women's.
"For women, there was relatively little change," Ford said.
Blacks with hypertension had a higher rate of death than whites
with hypertension in both time frames, although the gap narrowed a
Participants were followed for an average of 17.5 years in
NHANES I and 14.2 years in NHANES III.
The data also showed other differences between those with
hypertension and those without. Although cholesterol levels fell
for the general population, those with hypertension had a 45
percent smaller reduction.
Body mass index, a measurement of height and weight used to
identify obesity, increased overall, but slightly more among those
People with hypertension also were more likely over the years to
develop diabetes. About 5.9 percent of those with hypertension in
the 1970s had diabetes; by the 1990s, that figure rose to 11.4
Among people with normal blood pressure, diabetes incidence rose
from 2 percent to 3.5 percent.
On the positive side, smoking rates fell in the general
population since the 1970s, and even more so among those with
Dr. Donald LaVan, American Heart Association spokesman and
clinical associate professor of medicine at University of
Pennsylvania, noted that the definition of high blood pressure has
changed over the years. In the 1970s, he said, 160/95 mm Hg was
considered high blood pressure, while 140/95 was the threshold in
the 1980s, and today, 130/90 is considered elevated.
High blood pressure can raise the risk of heart disease and
stroke, and doctors today better understand the importance of
treating it, he added.
Though the data did not track if or how people were treated for
high blood pressure, better treatment is likely one reason for the
decline in death rates, LaVan suggested.
Today, in addition to the diuretics and beta blockers that were
used in the 1970s, doctors can prescribe ACE-inhibitors and
angiotensin II receptor blockers to treat high blood pressure, he
"The bottom line on this is, don't fool around with high blood pressure," LaVan said. "You've got to get your weight under control. Restrict sodium intake. Exercise. And you've got to take your medicine. It actually pays off. There is no question about it."
About 29 percent of adults in the United States had hypertension
in 2007-2008, a figure little changed from the 1980s, according to
background information in the study.
American Heart Association has more on high blood
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