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The number of adults in the United States with high blood pressure increased by 30 percent between 1988 and 2000, according to a study that analyzed government health statistics and other data gathered nationwide during the period.
The study found that at least 65 million Americans have hypertension, defined as blood pressure of 140/90 millimeters of mercury (mm Hg) or higher, using blood-pressure-lowering medications, or having been told at least twice by a physician or other health professional that they had high blood pressure. By that definition, almost a third of U.S. adults have hypertension.
"The bottom line is that the estimated number of adults with high blood pressure has increased," says Larry E. Fields, M.D., lead author of the study and senior executive advisor to the assistant secretary of the Department of Health and Human Services.
"High blood pressure is a major risk factor for coronary heart disease, kidney failure, heart failure, stroke, and other conditions. From a public and health professional perspective, it is important to be aware of high blood pressure, to have blood pressure checked regularly, and, if blood pressure is elevated, to initiate appropriate counseling and treatment," he says.
The findings came from an analysis of data from the U.S. Census Bureau and the 1999-2000 National Health and Nutrition Examination Survey (NHANES) IV, which included 4,531 people. The study was limited to people at least 18 years old. The new estimate is much higher than the previous NHANES report, based on data gathered between 1988 and1994, which estimated that at least 50 million U.S. adults had high blood pressure.
Blood pressure values were based on three measurements that a physician took during a single visit to a mobile examination center.
Fields and his associates estimated that 59.2 million people had hypertension on the basis of blood pressure measurements or prescriptions for blood pressure medication. More than 6 million people had high blood pressure based on their medical history, resulting in an estimated total of 65.2 million hypertensive adults.
The 1999-2000 survey shows that 28.7 percent of women and 28.3 percent of men have high blood pressure. When prevalence was divided along racial and ethnic categories, non-Hispanic black Americans have the highest prevalence at 38.8 percent. High blood pressure is prevalent in 28.7 percent of the Mexican-American population, and in 27.2 percent of the non-Hispanic white population.
The study, published in the Aug. 24, 2004, issue of Hypertension, did not specifically examine potential reasons for the increased prevalence of high blood pressure. However, the investigators cited the aging of the U.S. population and the growing proportion of overweight and obese Americans as potential major contributors.
"It has been demonstrated that interventions that center on health behavior, such as getting regular physical activity, controlling weight, and eating a nutritious diet that includes lots of fruits and vegetables and moderate amounts of salt, can reduce a person's chances of developing high blood pressure," says Fields.
A new study of older women indicates that regular walking is not just good for the body; it's good for the brain.
Researchers at the Harvard School of Public Health and three other institutions tracked the exercise habits of more than 18,000 older women over a period of eight to 15 years. Then, when the women reached age 70 and older, the researchers tested the women's cognitive abilities--their memory, learning, and attention--over a two-year period. They found that women who performed a moderate amount of activity, walking two to three hours at an easy pace every week, performed significantly better on these tests of cognition than women who walked less than one hour per week.
Women who engaged in the most activity--for example, walking at least six hours per week--had a 20 percent decrease in risk of cognitive impairment compared to those who were inactive, and they also demonstrated the cognitive functioning of someone three years younger than their actual age.
"Walking is a popular, accessible, and inexpensive activity for older adults that appears to provide many health benefits," says lead author Jennifer Weuve, Sc.D., of the Harvard School of Public Health. "In addition to studies showing a reduced risk of heart disease, pulmonary disease, and diabetes, a moderate level of walking also appeared to reduce the rate of cognitive decline in our study. What is most striking is that for older women who are able to engage in several hours per week of physical activity, their cognitive function seemed to be comparable to that of a woman several years younger."
Weuve and colleagues at Brigham and Women's Hospital in Boston analyzed the data from 18,766 U.S. women, ages 70 to 81 years, from the Nurses' Health Study. Women were assessed twice, two years apart, on general cognition, verbal memory, category fluency, and attention. They found that women who were more active and participated in
activities that ranged from walking at an easy pace to jogging experienced less cognitive decline than women who were not active.
Overall, the researchers found that the more active the individuals, the better their cognitive performance and the less decline they seemed to have. The findings are published in the Sept. 22, 2004, issue of the Journal of the American Medical Association.
"This is one of the first studies to explore the specific link between walking and cognitive function," Weuve says. "The health benefits of walking are becoming well-established and [this study] should provide older people with additional evidence to help encourage them to engage in walking or another form of physical activity."
Adults ages 65 years and older are the fastest-growing population in the United States and are at a high risk for dementia. Monitoring cognitive functioning and reducing risk factors associated with dementia are imperative to slowing its development.
The Nurses' Health Study was established in 1976 to study the relationship between the use of oral contraceptives and cigarette smoking and the risk of major illnesses. For a variety of reasons, including the dedication and commitment of the participants, the scope and range of the study has broadened over time to evaluate the implications of various lifestyle factors such as exercise and diet on women's health.