Adult hypertension cuts life expectancy and ups years lived with CVD

Shelley Wood

July 12, 2005

Framingham, MA - Adults with high blood pressure (BP) can expect to have lower life expectancy, fewer years lived without heart disease, and more years lived with it, a new study suggests. While previous research has pointed to an association between increased BP and reduced life expectancy, a Framingham cohort study indicates that the effect is much larger than previously thought. Dr Oscar H Franco (Erasmus Medical Center, Rotterdam, the Netherlands) and colleagues report their findings in the August 2005 issue of Hypertension, now available on the journal website [1].

"Our findings underline the tremendous importance of preventing high blood pressure and its consequences in the population," Franco et al note.

Franco and colleagues looked at data from 3128 participants in the Framingham Heart Study who had their 50th birthday while they were enrolled in the long-term study. They used multiple blood-pressure measurements taken between age 45 and 50 to best establish a baseline diagnosis of high, high-normal, or normal BP, adjusted for age, sex, and other confounders.

They report that for both men and women, total life expectancy declined, while the number of years lived with cardiovascular disease, MI, or stroke increased, in adults with high blood pressure at age 50, as compared with adults with normal blood pressure. Overall, total life expectancy was, on average, five years longer for both men and women who were normotensive at baseline.

Life expectancy and baseline BP: Male participants

BP category Total life expectancy Life expectancy free of CVD
Normal 29.7 24.5
High-normal 28.0 21.3
Hypertension 24.6 17.3

Life expectancy and baseline BP: Female participants

BP category Total life expectancy Life expectancy free of CVD
Normal 34.3 29.5
High-normal 33.3 27.6
Hypertension 29.4 22.4

"The major message from our study is that if hypertension is untreated from age 50 onward, these individuals have a greatly reduced life expectancy and an increase in the amount of years lived with cardiovascular disease, compared with those without hypertension," one of the study authors, Dr Anna Peeters (Monash University, Melbourne, Australia) told heart wire . "With the important caveat that our study did not specifically look at treatment, these results suggest that prevention or management of hypertension will improve people's life expectancy and quality of life."

The authors acknowledge that they did not evaluate high BP in relation to several other CVD risk factors, including cholesterol and physical activity, although factors such as smoking, body mass index (BMI), and education level were incorporated into the analysis. Another limitation of the study is the fact that the data used was collected three to five decades ago, when the Framingham study was launched, and may not accurately reflect the risk to 50-year-old hypertensives today.

"We expect that while the underlying risks remain the same, better treatment and management will mean that the cardiovascular disease and mortality risks are now less than seen in the Framingham Study," Peeters explained to heart wire . "Therefore, we expect the life-expectancy differences also to be lessbut it is too difficult to predict by what degree."

Still, write Franco and his coauthors, the findings "show that the association between increased BP levels and total life expectancy is higher than estimated previously, emphasizing the global need to improve BP control."


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