Lifetime Risk of Hypertension

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Hypertension is an increasingly important medical and public health issue. The prevalence of hypertension increases with advancing age to the point where more than half of people 60–69 years of age and approximately three-fourths of those 70 years of age and older are affected.1 The age-related rise in SBP is primarily responsible for an increase in both incidence and prevalence of hypertension with increasing age.15

Whereas the short-term absolute risk for hypertension is conveyed effectively by incidence rates, the long-term risk is best summarized by the lifetime risk statistic, which is the probability of developing hypertension during the remaining years of life (either adjusted or unadjusted for competing causes of death). Framingham Heart Study investigators recently reported the lifetime risk of hypertension to be approximately 90 percent for men and women who were nonhypertensive at 55 or 65 years and survived to age 80–85 (figure 8).16 Even after adjusting for competing mortality, the remaining lifetime risks of hypertension were 86–90 percent in women and 81–83 percent in men.

Figure 8

Figure 8

Residual lifetime risk of hypertension in women and men aged 65 years Cumulative incidence of hypertension in 65-year-old women and men. Data for 65-year-old men in the 1952–1975 period is truncated at 15 years since there were few participants (more...)

The impressive increase of BP to hypertensive levels with age is also illustrated by data indicating that the 4-year rates of progression to hypertension are 50 percent for those 65 years and older with BP in the 130–139/85–89 mmHg range and 26 percent for those with BP between 120–129/80–84 mmHg range.17