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High Blood Pressure: a Worldwide Problem

Por Ed Edelson* -

Nearly 1 billion people worldwide have high blood pressure, and that number is expected to increase to 1.56 billion people by 2025, a new study predicts.

The estimates come from pooled data of 30 population-based studies involving more than 700,000 people from different regions of the world, according to a report published in The Lancet.

The greatest increase is expected in underdeveloped regions such as Africa and Latin America, said study author Dr. Jaing He, chairman and a professor of epidemiology at the Tulane University School of Public Health and Tropical Medicine.

"The increased incidence of high blood pressure, a major risk factor for heart attack, stroke and other cardiovascular conditions, is an ironic byproduct of Westernization, which enables people to live longer but can also lead to unhealthy lifestyles," he said. "The world population is getting older, and older people have a much higher risk of hypertension [high blood pressure]."

The report found that 333 million adults in economically developed regions such as North America and Europe had high blood pressure in 2000, with an additional 639 million people in developing countries having the condition. The prevalence is predicted to increase by 24% in developed countries and 80% in developing countries, the study said. "The best way to reduce the incidence of high blood pressure is to create national and international programs that concentrate on healthy lifestyle changes," Dr. Jaing He said.

"Health policymakers need to pay attention to hypertension. They should promote a low-sodium diet, physical activity and adequate fruit and vegetable intake," according to Jaing He.

While medicines can help control high blood pressure, the most important factor will be lifestyle changes. "Hypertension has been an emerging global problem for some time," said Dr. James W. Reed, a professor of medicine at Morehouse School of Medicine in Atlanta, and a board member of the International Society on Hypertension in Blacks. "We have been going around the world trying to do something about it for the past 19 years," Reed said. "We have had campaigns in African countries such as Kenya, and also in South America and the Caribbean."

But, Reed said, "there is no way we could have a budget large enough to do what has to be done. Someone like the World Health Organization has to take the initiative."

We need a global strategy for addressing the issue, according to Reed. "Medication can help, but there is no way to make enough medication to meet the need. Some of the things we are doing to ourselves in terms of the way we live have more impact than any medication." Another report in the same issue of the journal singled out a medical risk factor for one hypertension-related problem--stroke. Researchers at University College London said they have linked an increased risk of stroke to high blood levels of the amino acid homocysteine.

Previous studies have uncovered such a relationship, but those findings were clouded by other risk factors, such as smoking and socioeconomic class. The new study steered clear of those factors by looking at a gene that controls blood levels of homocysteine. Persons with a gene that gives them a higher blood level of homocysteine have an increased incidence of stroke, the researchers found.
Homocysteine levels can be reduced by daily doses of folic acid. But a large-scale study is needed to determine whether folic acid supplements can reduce the incidence of stroke, the researchers said.

SOURCES: Jaing He, M.D., Ph.D, chairman and professor, epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans; James W. Reed, professor, medicine, Morehouse School of Medicine, Atlanta; Jan. 15, 2005, The Lancet

*HealthDay Reporter


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