Uneven impact of high blood pressure
High blood pressure does not affect all people, races, or genders alike. For example, men are more likely to develop the condition than women up to the age of 55, while aging women between 55 and 74 become more likely than men to get high blood pressure. In fact, some statistics indicate that the condition is harder on women than men. In 1999 alone, the high blood pressure mortality rate for men was 17,194 as compared to 25,803 for women.
A much more startling difference is the impact that high blood pressure has on African Americans, who are among the most likely groups in the world to develop the condition. Over 50% of African-American males are said to have high blood pressure, while a little less than half of women from this group suffer from it. In addition, African Americans are also much more likely than white Americans to develop high blood pressure at an early age and to have higher average readings. The overall death rate from high blood pressure in 1999 for white men and women was 12.8 per 100,000 — as compared to 40.3 per 100,000 for black females and 46.8 per 100,000 for black males. On average, African Americans with high blood pressure have a much greater rate of stroke, heart failure, and other diseases than whites. In the area of kidney failure alone, African Americans between 25 and 44 years old are 20 times more likely than whites to develop this hypertension-related disease. On the positive side, African Americans are considered more “salt sensitive” than other groups and can substantially improve their blood pressure levels by losing weight and reducing their sodium intake.
Another key group that is more likely to develop high blood pressure is older people, since levels tend to rise as people become older. Over 50% of Americans over 60 years old have high blood pressure, and over 65% older than 75 suffer from the condition. This is because, as people age, the arteries become harder and less flexible, causing the heart to work harder to pump blood throughout the body. When this takes place, only the systolic blood pressure increases, causing what is called isolated systolic hypertension (ISH). In general, doctors have to be careful when monitoring the blood pressures of older people because readings can vary greatly within the first several minutes of an office visit.
On a positive note, older adults who lead stable, active lives may be able to sustain normal blood pressures throughout life. For those who are inactive or have unhealthy lifestyles, studies have shown that medical treatment for high blood pressure has proven to be effective in lowering the risk of heart attacks, strokes, and other complications in older patients.
Geography may also play a role in the development of high blood pressure in the United States. For example, research has shown that African Americans and whites living in the southeastern U.S. have a higher risk of high blood pressure and stroke than Americans living in other regions. Part of the reason for this discrepancy is that people living in this area are more likely to be from lower economic and educational backgrounds, which make people in general more susceptible to anxiety, depression, and diets that are high in salt and poor in nutrition. In fact, many of the states within this region have 10% higher stroke rates than other parts of the country. The 11 states that make up the so-called “stroke belt” are Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Virginia. It still remains unclear the extent to which environment or genetics are influencing these marked differences.
Uneven Impact of HBP — High Blood Pressure in Women and Children
WOMEN
As previously mentioned, women appear to suffer from high blood pressure later in life, as compared to men. However, high blood pressure does have a particular impact on women during pregnancy and menopause.
Studies have shown that high blood pressure is common in up to 15% of all pregnancies. Doctors usually monitor blood pressure levels closely during the last three months of pregnancy, when it can quickly develop. For mothers who already have high blood pressure before their pregnancy, their blood pressure levels should be properly treated and may become even worse. For mothers who develop hypertension during the pregnancy, they face the risk of harming themselves and their baby if it is not treated properly. In many patients, high blood pressure subsides after birth.
Older women are also prone to develop high blood pressure after menopause, when hormone changes in their bodies make them susceptible to the condition. Though research has not yet uncovered the kinds of specific effects menopause has on high blood pressure, doctors recommend that older women carefully monitor their blood pressures on a regular basis.
CHILDREN
Though high blood pressure in children is largely uncommon — about 1 percent of all children in the U.S. — the children of parents who have the condition are 20 to 30 percent more likely to develop high blood pressure than those with parents with normal blood pressures. Another potential cause is the lifestyle habits that children and adolescents learn from their parents or siblings. For example, children are more likely to develop high blood pressure as adults if they have poor diets, smoke or drink, take drugs, or are inactive or overweight. For these and other reasons, it is recommended that children have their blood pressure taken on regular intervals when they are as young as three years old. In the rare cases when children develop severe high blood pressure, it is usually a symptom of a more serious problem, like heart irregularities or kidney disease.
The impact of high blood pressure on other racial groups in the country is more even. For example, Hispanic and Native Americans have similar rates of developing hypertension as whites, while Asian/Pacific Islanders have the lowest rates among all minority groups. The only problem is that high blood pressure is not being adequately addressed or treated among these groups — particularly African and Hispanic Americans — causing yearly mortality rates from heart disease and stroke to be unnecessarily high.
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