NEW YORK (Reuters Health) - Middle-aged and the elderly face a 90% chance of developing high blood pressure during their lives, researchers have found.

Since high blood pressure boosts the odds of heart disease, stroke and kidney disease, this lifetime risk represents a "huge public health burden," according to the report in the February 27th issue of The Journal of the American Medical Association.

But the burden need not be so heavy, as high blood pressure is closely linked to lifestyle factors including inactivity and unhealthy eating habits, the study's lead author told Reuters Health.

"We know that high blood pressure is preventable," said Dr. Ramachandran S. Vasan, of the National Heart, Lung, and Blood Institute's Framingham Heart Study--a long-running study of cardiovascular health among men and women that began in 1948 in Framingham, Massachusetts.

Vasan noted that people of any age can reduce their risk of developing high blood pressure, or hypertension, by maintaining a healthy weight; getting regular, moderate exercise; following a diet low in fat and sodium, and rich in fruits and vegetables; not smoking; and limiting alcohol.

And although it's best to practice these habits over a lifetime, "it's never too late to start," Vasan said.

His team looked at nearly 1,300 men and women in the Framingham study who were between the ages of 55 and 65 at the start of the analysis. They determined the participants' risk of developing high blood pressure between 1976 and 1998, and compared this risk with that of participants followed from 1952 to 1975.

Overall, the chances that the more recent group would develop stage 1 hypertension were 90%, the investigators found. Men in this group were 60% more likely than men in the 1952-1975 group to be diagnosed with stage 1 hypertension, while women's risk remained stable over time.

Stage 1 hypertension refers to blood pressure at or beyond the cutoff point for desirable blood pressure--140/90 mm Hg. Stage 2 hypertension is defined as blood pressure of 160/100 mm Hg or higher. In the study's bright spot, men and women in the more recent group were less likely than their predecessors to develop this more severe hypertension.

This is likely due to the substantial increase in drug treatment for hypertension over time, Vasan explained.

But although this decline in stage 2 hypertension "represents a major achievement," he and his colleagues conclude, more needs to be done to prevent elevated blood pressure in the first place.

Vasan noted that the lifetime risk in this study did not just reflect risk "late in life." More than half of 55-year-old participants developed high blood pressure within 10 years, his team found.

SOURCE: The Journal of the American Medical Association 2002;287:1003-

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