Contribution
of High Blood Pressure to SF Burden of Disease
An estimation of
the contribution of high blood pressure to the overall burden of disease
in San Francisco is difficult for two reasons:
1. While we have
survey data on the percent of adults who say they have been diagnosed
with hypertension (19% for Latinos; 19% for Whites; 24% for Asians;
50% for African Americans; or 22% for all San Franciscans) [CHIS],
we don't know the distribution of these blood pressures. The risk of
cardiovascular disease doubles for each 20 mm Hg increment in systolic
blood pressure.
2. The above-stated
increments in risk begin above 115/75 mm Hg, and there are ample data
demonstrating that those with "prehypertension" (defined in
table on the Overview
page) contribute
substantially to the burden of "non-optimal blood pressures."
We don't know what proportion of our local population has "non-optimal
blood pressures."
Therefore, until
more precise data can be generated, we might look to the Global Burden
of Disease Study, which estimated that nearly two-thrids of strokes
and half of ischemic heart disease can be attributed to systolic blood
pressure greater than 115 mmHg [Lawes
2006]. If these estimates are applied to Years of Lost Life San
Francisco, 2000-2001 (see Health
Outcomes), the combined attributable premature mortality from hypertension
would rank as the second leading cause of death.
