Strokes More Common in Europe Than U.S., New Study Shows

Newswise — Although 29 percent of Americans with high blood pressure of 140/90 mm Hg have it controlled, less than 11 percent of Europeans do, showing why strokes are twice as common in Europe than the U.S, according to a study in the January 2004 issue of Hypertension: Journal of the American Heart Association.

Researchers at Loyola University Health System studied hypertension prevalence, treatment and control among the 35- to 64-year-old population of five European countries, Canada and the U.S.

"Only 5 percent of people in Spain and 10 percent of people in England with this blood pressure had it controlled," said study co-author Dr. Richard S. Cooper, chair, department of preventive medicine and epidemiology, Loyola University Chicago Stritch School of Medicine. Based on a threshold of 140/90 mm Hg, control rates were 5.5 percent in Sweden; 7.8 percent in Germany; 9 percent in Italy; and 17.2 percent in Canada.

"We found divergent views between countries on what blood pressure level requires treatment," said Cooper. "Low treatment and control rates in Europe, combined with a higher prevalence of hypertension, could contribute to a higher burden of cardiovascular disease risk. "The public health impact of these various standards for treatment urgently needs to be evaluated," said Cooper. Among hypertensives in Canada and Europe, 66 percent to 75 percent were untreated, compared to the U.S., where slightly less than 50 percent of people with high blood pressure of 140 mm Hg are untreated.

Researchers also found that control was 2-fold higher in women compared with men in Spain, Italy, Canada and the U.S.

"Much of the variation in the success rate in hypertension control appears to be related to the treatment strategy adopted by individual countries," said Cooper.

He said that to concentrate only on high-risk patients will limit the public health impact of blood pressure control, because low-risk persons account for most of the population-attributable risk.

Co-authors of the study, "Hypertension Treatment and Control in Five European Countries, Canada and the United States," are Dr. Katharina Wolf-Maier, Dr. Richard S. Cooper and Dr. Holly Kramer, Loyola University Health System; Jose R. Banegas, Madrid; Simona Giampaoli, Rome; Michel R. Joffres, Halifax, Nova Scotia; Neil Poulter and Paola Primatesta, London; Birgitta Stegmayr, Umea, Sweden; and Michael Thamm, Berlin.

Visit the Loyola University Health System Web site http://www.luhs.org for more information.

Loyola University Health System, a wholly owned subsidiary of Loyola University Chicago, includes Loyola University Medical Center (LUMC), 18 specialty and primary care centers in the western and southwestern suburbs, the Loyola Ambulatory Surgery Center at Oakbrook, the Loyola Imaging Center at Oakbrook Terrace, a joint venture with the Rehabilitation Institute of Chicago, and serves as co-owner-operator of RML Specialty Hospital, a long-term-care facility for ventilator-dependent patients in suburban Hinsdale, Ill. LUMC, a private, academic health care institution, is nationally recognized for its specialty care and research in such areas as cancer, cardiology and cardiovascular surgery, pediatrics, neonatology and neurosciences, burn and trauma care and organ transplantation. The 73-acre campus in Maywood, Ill., includes the 523-bed licensed Loyola Hospital with a Level I trauma center, Russo Surgical Pavilion, Cardiovascular Institute, Cardinal Bernardin Cancer Center, Ronald McDonald Children's Hospital of LUMC, Loyola University Chicago Stritch School of Medicine, the Loyola Outpatient Center, 24-bed RIC & LOYOLA acute rehabilitation unit, the region's largest burn unit and one of the Midwest's largest and most comprehensive organ transplant programs.