World Blood Pressure Rises

The numbers are a shock: Almost 1 billion people worldwide have high blood pressure, and more than half a billion more will harbor this silent killer by 2025.

It is not just a problem for the ever-fattening Western world, either. Even in parts of Africa, high blood pressure is becoming common.

That translates into millions of deaths from heart disease alone. Yet hypertension does not command the attention of, say, bird flu, which so far has killed fewer than 200 people.

"Hypertension has gone a bit out of fashion,"" says Dr. Jan Ostergren of Sweden"s Karolinska University Hospital, who co-authored a first-of-its-kind analysis of the global impact of high blood pressure.

"Even in the US, the majority of people with high blood pressure are not treated adequately,"" says Dr. Sidney Smith of the University of North Carolina at Chapel Hill, who advises the World Heart Federation. "Look at China, look at Africa; go around the world. It is a major risk factor.""

And the dangers go well beyond the heart. High blood pressure is a leading cause of strokes and kidney failure. It also plays a role in blindness and even dementia.

Patients seldom notice symptoms until organs already are damaged.

Yet treating high blood pressure before that happens is a medical best-buy. Improving diet and exercise can help. When that"s not enough, blood pressure drugs are among the oldest and thus cheapest on the market 21 cents a day for a leading diuretic.

Ostergren joined experts from the London School of Economics and the State University of New York to assemble two teams of specialists and map what they call the coming crisis of hypertension: 1.56 billion people are expected to have it by 2025.

Normal blood pressure is measured at less than 120 over 80. Anyone can get high blood pressure, a level of 140 over 90 or more. But being overweight and inactive, and eating too much salt, all increase the risk. So does getting older.

The world"s population is aging and fattening, fueling a continued increase in blood pressure problems. Remarkably, the report cites worse hypertension rates in much of Western Europe than in the United States, despite cultural similarities: 38 percent in England, Sweden and Italy; 45 percent in Spain; 55 percent in Germany.

But the biggest jump is expected in developing countries and nations rapidly moving to more Western-style economies, the report warns. In parts of India, studies suggest one in three urban adults has high blood pressure, while it is still rare in rural areas with more traditional lifestyles. More

than a quarter of adults in China have hypertension. So do one in four in Ghana and South Africa.

Treatment is difficult, because patients often quit their medicine, not understanding it is necessary even when they feel good. Also, doctors may be reluctant to prescribe the two- or three-drug combinations that half of patients wind up needing.