Death rates among those with high blood pressure decreasing, but still high

Death rates have decreased among people with high blood pressure but remain far higher than in those without it, according to research in Circulation: Journal of the American Heart Association.

Researchers examined changes in death rates among adults ages 25 to 74, using results from two national health surveys: The National Health and Nutrition Examination Survey (NHANES) I Epidemiologic Follow-up Study followed participants recruited between 1971 and 1975 and the NHANES III Linked Mortality Study followed participants recruited between 1988 and 1994.

The study found:

• The overall death rate (number of deaths for every 1000 person-years and adjusted for age) was 18.8 among NHANES I participants with high blood pressure — 42% higher than in those without it (13.3).
• From NHANES I until NHANES III, mortality rates had fallen to 14.3 in hypertensive patients — 57% higher than in those without high blood pressure (9.1). 
• Although men were more likely to die than women in both time periods, the decline in deaths among hypertensive men (7.7, a 33% relative reduction) was more than four times larger than among hypertensive women (1.9, a 12% relative reduction).

"On average, hypertensive women had larger declines in their blood pressure than hypertensive men, but didn't do as well in other measures related to heart disease risk," the researchers said. "Compared with hypertensive men, women gained more weight, were more likely to be diagnosed with diabetes and were less likely to quit smoking."
Between the two surveys, hypertensive patients had a:

• 45% smaller reduction in total cholesterol levels
• 30% larger increase in body mass index 
• 3.6 times larger increase in the diagnoses of diabetes 
• 25%larger decrease in the percentage of smokers