~ Strong Link Between High Blood Pressure and Death

A meta-analysis published in the December 14 2002 issue of The Lancet demonstrates an even greater association than previously believed between deaths from cardiovascular disease and high blood pressure. The Prospective Studies Collaboration examined 61 studies providing information on close to one million participants from Europe, North American, Australasia, China and Japan.

Over the course of the 61 studies, there were 120,000 deaths. The investigators found a strong association between blood pressure readings and risk of cardiovascular death down to a below normal reading. For participants between the ages of 40 to 69, a difference of 20 mm Hg systolic or 10 mm Hg diastolic was associated with a twofold difference in stroke, heart disease and other vascular disease.

Researcher Sarah Lewington, of the Clinical Trial Service Unit and Epidemiological Studies Unit in Oxford, England, commented, "Not only do the present analyses confirm that there is a continuous relationship with risk throughout the normal range of usual blood pressure (down at least as far as 115/75 mm Hg), but they also demonstrate that within this range the usual blood pressure is even more strongly related to vascular mortality than had previously been supposed.

Randomized trials (which typically last only a few years) have shown that blood-pressure lowering can produce rapid reductions in vascular disease risk, and this meta-analysis provides complementary evidence of the even greater differences in risk that are likely to be produced by really prolonged differences in blood pressure.

For example, a 10 mm Hg lower usual systolic blood pressure or 5 mm Hg lower usual diastolic blood pressure would, in the long term, be associated with about 40% lower risk of stroke death and about 30% lower risk of death from ischemic heart disease or other vascular causes throughout middle age.

For the general population, producing persistent reductions in average blood pressure of just a few mm Hg by some widely practicable methods (such as, perhaps, reducing sodium intake in manufactured foods) should avoid large absolute numbers of premature deaths and disabling strokes, especially in places that, perhaps for other reasons, have relatively high stroke rates (such as Northern China) or high IHD [ischemic heart disease] rates (such as Eastern Europe)."

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