Is Hypertension Changing? Blood Pressure Development in Cohorts of 50-yearold Men Between 1963 and 1993

Abstract

Ribacke M, Tibblin G, Rosengren A, Eriksson H. Is Hypertension changing? Blood pressure development in cohorts of 5-years-old men between 1963 and 1993. Objective: To study secular trends in the prevalence and treatment of hypertension in the general population, and the disease course. Design: Health examinations of cohorts of 50-year-old men in 1963, 1973, 1983 and 1993. Setting: The city of Göteborg, Sweden (about 400 000 inhabitants). Participants: Random population samples of 50-year-old men. Main outcome measure: Mean blood pressure (BP) levels in the populations and among treated hypertensives, proportions of hypertensives, and frequency of high BP values (≤ 160/and or 95, and ≤ 175/115 mmHg, respectively). Results: The mean population BP decreased from 138.4/89.0 mm to 128.7/84.4 mmHg during the 30-year period (p < 0.0001). Mean BP levels among treated hypertensives decreased from 170/113 to 142/94 mmHg (p < 0.001), and the proportion of men with high BP values diminished from 3.9 to 0.1%. Also BP levels among normotensives decreased significantly (p < 0.0001). Conclusion: The findings could partly be seen as a result of successful case-finding and treatment of hypertension in the region, but alteration of the natural course of hypertension cannot be excluded.