9 in 10 Will Develop Hypertension?

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9 in 10 Will Develop Hypertension?

High blood pressure is a frequent precursor of cardiovascular disease. An individual's long-term risk for developing high blood pressure can best be determined as a "lifetime risk" - the odds that a person will develop hypertension over his or her remaining lifetime.

The authors of this study determined residual lifetime risk for 1,298 subjects aged 55-65 years at baseline and hypertension-free, all participating in the Framingham Heart Study (FHS). Hypertension was defined as a blood pressure of 140/90 mm Hg or more, or the use of antihypertensive medications.

The lifetime risk for the development of hypertension or stage 1 high blood pressure or higher (hypertension regardless of medication use) was 90% in both age groups. The odds for receiving antihypertensive medication in a subject's lifetime were 60%. Hypertension risk increased 60% in men, but not women, from the 1952-1975 period of the FHS to the 1976-1998 period. Risk for stage 2 high blood pressure (at least 160/100 mm Hg) dropped in both sexes in the recent period, however.

The authors conclude, "The finding that 9 out of 10 middle-aged and older adults are likely to develop elevated blood pressure over their remaining lifetime reemphasizes that hypertension poses a major public health burden." This burden will likely increase as the U.S. population ages in the near future. The authors suggest, "The immediacy and the magnitude of this risk should encourage middle-aged nonhypertensive individuals to adopt lifestyle-related measures for maintaining optimal blood pressure for preventing the development of hypertension."

Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hypertension in middle-aged women and men: The Framingham Heart Study. Journal of the American Medical Association 2002:287(8), pp. 1003-1010.