High Blood Pressure – USA vs. Rest-of-the-World

Well, maybe not the rest of the world, but Europe, anyway. It’s about time the USA topped Europe in one are of medicine, after accounts of them being outplayed in antibiotic use, childbirth complications, and infant death rates.

The Archives of Internal Medicine contains an article comparing the blood pressure readings in people diagnosed with hypertension in Europe with those in the USA. The data came from 290 cardiologists and 1250 primary care doctors in the USA and five European countries – France, Germany, Italy, Spain, and the UK. The physicians kept two–page diaries for 15 consecutive cardiovascular patients.

In the more than 20,000 patients from these 6 countries, the average age was 65, 53% were male, and 23% had diabetes. The initial blood pressures (before treatment) averaged 161/94 mm Hg in the USA, and between 167/96 to 173/99 in the European countries. The most recent readings (i.e. under treatment) averaged 134/79 mm Hg in the USA, and between 139/80 to 144/84 in Europe. The rate of control (i.e. the latest blood pressure reading below 140/90 mm Hg) was 63% in the USA vs. 31% to 46% across Europe.

American physicians tended to start medication earlier, using a slightly lower threshold reading to begin treatment. ‘Water pills’ (thiazides) were used equally by all countries, but combination drug therapy was as high as 64% in the USA vs. 44% to 59% in Europe.

If we accept that adequate treatment of high blood pressure is desirable and is linked to lower death rates and cardiovascular events like heart attack, stroke, and heart failure, it’s clear that, at least for once, the USA leads.

Comments

[Gary Booth]

You state: "If we accept that adequate treatment of high blood pressure is desirable and is linked to lower death rates and cardiovascular events like heart attack, stroke, and heart failure...". That is a BIG IF!
What if we don't accept this hypothesis?
How about an alternate hypothesis: Drugs that lower blood pressure, given to people with hypertension, increase the rate of mortality over people with hypertension that don't take the drugs. This should be an easy study to do, whether in the USA or world wide, since so many people with hypertension take these drugs.
There is no doubt in my mind that the real question is: How do we prevent damage to the cardiovascular system? I believe that Mathias Rath, MD in his book, "Why Animals Don't Get Heart Attacks ... But People Do!" gives the correct answer; that Vitamin C, (ascorbic acid) prevents cardio-vascular disease.