News Release

Southerners at increased risk for high blood pressure

Peer-Reviewed Publication

American Heart Association

American Heart Association journal report Southerners at increased risk for high blood pressure

DALLAS, Jan. 7 -- High blood pressure, a major risk factor for stroke, is more prevalent among Southerners than their non-Southern counterparts of the same age and gender, according to a new study in this month's Stroke: Journal of the American Heart Association.

Researchers examined data on 6,278 Caucasians and African Americans who took part in the Third National Health and Nutritional Examination Survey (NHANES III) from 1988 to 1994. The new study found that even after controlling for factors such as age and gender, Southerners were more likely to have high blood pressure readings than non-Southerners. A reading of 140/90 millimeters of mercury (mm/Hg) or higher was considered high blood pressure.

Prevalence of high blood pressure was higher among 60 to 79 year old Southern residents compared with non-Southern residents of the United States (59 percent vs. 54 percent). A higher percentage of older Southern white men (60 to 79 years of age) had high blood pressure compared with similar ethnic-gender groups in the non-Southern region.

States included in the authors' definition of the "South" were: Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia and West Virginia. Washington D.C. was also included. Many of these same states comprise the "stroke belt" -- a region of the United States that has a greater proportion of strokes.

"Lack of access to healthcare, lower socioeconomic status, environmental factors and even dietary differences such as higher-sodium and lower-potassium diets may contribute to the geographic variation," says the study's lead author Thomas O. Obisesan, M.D., M.P.H., assistant professor of medicine at Howard University Hospital in Washington, D.C. "There are a number of possibilities."

Compared with their non-Southern counterparts, older African-American men in the South demonstrated higher awareness (78.3 percent vs. 67.3 percent) and treatment of high blood pressure (65.7 percent vs. 53.1 percent) but had a lower rate of blood pressure control with medication (34.5 percent vs. 45.4 percent).

"We found that even though awareness of high blood pressure had increased, we're still not controlling it as well as we should," says Obisesan. "Patients have not been compliant in taking their medication and perhaps physicians have not been aggressive enough in treating high blood pressure."

Further examining the data, researchers also found differences in high blood pressure rates along urban/rural lines. By studying data on African-American men, the researchers found that 70.4 percent of African-American men living in non-metro areas in the South had high blood pressure, compared to 54.3 percent of African-American men living in Southern metropolitan areas.

"Several interventions targeting lifestyle risk factors for high blood pressure currently exist," says Obisesan. "However, for these interventions to have optimal benefit, it is important to target high-risk populations."

High blood pressure is one of several risk factors for stroke that can be improved through treatment or behavior change. Others include smoking, obesity, physical inactivity and diabetes. Risk factors that cannot be changed include race, sex and age.

"Once physicians recognize the patient has high blood pressure, there needs to be follow-up with aggressive treatment and a strong patient effort to follow doctor's orders," says Obisesan. "What we're seeing is much different -- a lack of aggressiveness and a lack of compliance leading to more instances of uncontrolled high blood pressure, which can lead to more strokes."

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Co-authors are Clemencia M. Vargas, D.D.S., M.P.H., Ph.D. and Richard F. Gillum, M.D.

Media Advisory:
Dr. Obisesan
tobisesan@fac.howard.edu.

CONTACT:
For journal copies only, please call 214-706-1173

For information, call Carole Bullock
caroleb@heart.org
214-706-1279

Brian Henry
214-706-1135


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