Heart failure, in which the heart loses its ability to pump enough blood throughout the body, typically develops gradually over the years. The severity of the disease depends on how much pumping capacity is lost. Normally, pumping capacity decreases with age, but the loss is significantly more in heart failure and often results from a heart attack or other disease that injures the heart.
To evaluate the contribution of high blood pressure to the development of heart failure, data were obtained on more than 5000 people recruited for the NHLBI-funded Framingham (MA) Heart Study,one of the largest and most comprehensive ongoing investigations of the prevalence, incidence, and risk factors of heart disease. Male and female participants, who ranged in age from 40 to 89, underwent periodic examinations for approximately two decades beginning in January 1970.
The researchers, led by Dr. Daniel Levy, director of the Framingham Heart Study, found that 91% of the 392 participants who developed heart failure had high blood pressure, making it the most common risk factor for heart failure. High blood pressure accounted for 39% of heart failure cases in men and 59% in women.
This type of analysis provides important information about the factors involved in the progression of heart failure, explains Dr.Levy. "Prior to this study the magnitude of the contribution of high blood pressure to the development of heart failure had not been recognized." Other risk factors for heart failure include previous heart attacks, diabetes, and heart disease.
The participants with high blood pressure were categorized as having either Stage 1 hypertension (blood pressure of 140-159 / 90-99 mm Hg {millimeters of mercury} and not on medication), or Stage 2 (160 /100 mm Hg or greater, or currently on blood pressure medication). Among those with high blood pressure who developed heart failure, 76% of the men and 82% of the women had Stage 2 or greater high blood pressure. The average age for developing heart failure in this study was 73 years in men and 78 in women.
This study, says Levy, "reinforces the concept that blood pressures in the higher range (and of long duration) increase the risk of heart failure."
However, concludes Levy, "the good news is that a prevention strategy based on earlier detection and more aggressive treatment of high blood pressure may reduce the incidence of heart failure in the general population. High blood pressure is easily identified and treated."
An estimated 50 million Americans have high blood pressure, which also puts them at increased risk for heart attacks, stroke, and kidney disease.
The researchers offer the following advice for individuals interested in controlling their blood pressure.
If non-drug treatment fails to lower blood pressure, explore the possibility of drug treatments.
This research was published in the May 22/29,1996 issue of The Journal of the American Medical Association. --an NIH HEALTHWise report, October 1996
Maintaining a normal weight and engaging in regular physical activity may help prevent high blood pressure.
High blood pressure increases with age. More than half of all Americans over 65 have high blood pressure.
African Americans develop high blood pressure at an earlier age and have more severe high blood pressure than whites.
For more information on this study, reporters can contact:
For more information on high blood pressure and on heart failure and to obtain publications, please write to:
NHLBI Information Center Attention: HEALTHWise P.O. Box 30105 Bethesda, MD 20824-0105
For recorded information on high blood pressure prevention and treatment call: 1-800-575-WELL
Know your blood pressure. If it's 140/90 mm Hg or above, discuss with your doctor whether treatment is indicated. In many cases, non-drug approaches, such as diet and exercise may be all that's needed.
