Northern Europeans, Americans more likely to die from hypertension

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January 6, 2000

Web posted at: 11:33 AM EST (1633 GMT)

http://www.cnn.com/2000/HEALTH/01/06/blood.pressure.ap/index.html

 

(AP) -- American and Northern European men with high blood pressure are three

times more likely to die of a heart attack than men with the same blood pressure

from Japan or the Mediterranean coast of Europe, researchers reported today in

the New England Journal of Medicine.

 

Although genetics may explain some of the difference, diet also plays an

important part, the researchers said.

 

" As compared with the diets in Northern Europe and the United States, the

Mediterranean diet at base line contained less meat and fewer dairy products,

but more olive oil, fish, fruits, vegetables and alcohol, " they said.

 

Researchers from the Netherlands analyzed data on 12,031 middle-aged men in six

geographic areas and found that in every region, the risk of death from coronary

heart disease increased as blood pressure rose.

 

Overall, the risk of death rose 28 percent for each 10-point increase in

systolic blood pressure (the first number in the blood pressure reading) or each

5-point increase in diastolic blood pressure.

 

But the number of deaths varied widely from place to place.

 

For example, among men with a systolic blood pressure of 140, there were about

70 deaths per 10,000 person-years in Northern Europe and the United States,

compared with 20 deaths in Japan and the Mediterranean. A person-year is a

measure of the number of years lived by the participants after the study began.

 

Dr. Richard Pasternak, a spokesman for the American Heart Association and

director of preventive cardiology at Massachusetts General Hospital, said the

research provides further evidence that lifestyle, not genetics, should be the

main focus of efforts to prevent heart disease.

 

" If you eliminate the factors that we know about, which are largely lifestyle

issues -- smoking, high blood pressure, high cholesterol, lack of exercise and

diabetes -- you can eliminate somewhere between 70 and 90 percent of disease in

our population, " Pasternak said.

 

For a long time, doctors have defined high blood pressure as 140 over 90 and

higher. But the study adds to a growing body of evidence that people who fall

below that mark can still benefit significantly by cutting their blood pressure

further.

 

" This makes it clear the risk is pretty continuous, " Pasternak said. " Taking

someone from 135 to 125 would lower their risk by 25 or 30 percent. "

 

The study also suggests that doctors in Northern Europe, the United States and

other high-risk areas should treat high and moderately elevated blood pressure

more aggressively than doctors in Japan and the Mediterranean, said Dr. Teri

Manolio, who directs several large heart-disease studies for the National Heart,

Lung and Blood Institute.

 

The men were enrolled in the study between 1958 and 1964 and followed for 25

years. They were 40 to 59 years old when they joined the study.

 

After adjusting for age, smoking and cholesterol levels, the study found the

highest rates of death from coronary heart disease among Northern European and

American men. Serbian and inland southern European men had average death rates,

and Japanese and Mediterranean European men had the lowest.

 

The study was led by Peggy van den Hoogen of the National Institute of Public

Health and the Environment in Bilthoven, the Netherlands.

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