title: Blood pressure changes during 22-year of follow-up in large general population - the HUNT Study, Norway.
abstract: BACKGROUND
  While hypertension still is a major health problem worldwide, some studies have indicated that the blood pressure level has decreased in some populations. This population based cohort study aims at analysing blood pressure changes in a large Norwegian population over a 22 year period.
  
  
  METHODS
  Data is acquired from three comprehensive health surveys of the HUNT Study conducted from 1984-86 to 2006-08. All citizens of Nord-Trøndelag County, Norway, >20 years were invited: 74,549 individuals participated in 1984-86; 64,523 in 1995-97; and 43,905 in 2006-08.
  
  
  RESULTS
  Both systolic and diastolic blood pressure levels decreased substantially from mid 1980s to mid 2000s, with the most pronounced decrease from 1995-97 to 2006-08 (from 136.0/78.9 to 128.3/70.9 mmHg in women and from 140.1/82.1 to 133.7/76.5 mmHg in men). Although the use of blood pressure lowering medication increased, there was a considerable decrease even in those who reported never use of medication (mean decrease 6.8/7.2 mmHg in women and 6.3/5.3 mmHg in men), and the decrease was most pronounced in the elderly (mean decrease 16.1/12.4 mmHg in women and 14.7/10.4 mmHg in men aged 80+). Mean heart rate, total cholesterol and daily smoking decreased, self-reported hard physical activity increased, while body weight and the prevalence of diabetes increased during the same period.
  
  
  CONCLUSIONS
  The BP decrease might seem paradoxically, as body weight and prevalence of diabetes increased during the same period. Salt consumption might have decreased, but no salt data is available. The parallel decrease in mean heart rate might indicate reduction in the white-coat phenomenon, or increased use of beta blockers or calcium channel blockers for other diagnosis than hypertension. Additionally, the data could support the "healthy obese" hypothesis, i.e., that subgroups in the population can sustain obesity without serious health consequences.
authors.affiliation: HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Forskningsvegen 2, 7600, Levanger, Norway. jostein.holmen@ntnu.no.
authors.forename: Jostein
authors.initials: J
authors.lastname: Holmen
authors.affiliation: HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Forskningsvegen 2, 7600, Levanger, Norway.
authors.forename: Turid Lingaas
authors.initials: TL
authors.lastname: Holmen
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Aage
authors.initials: A
authors.lastname: Tverdal
authors.affiliation: HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Forskningsvegen 2, 7600, Levanger, Norway.
authors.forename: Oddgeir Lingaas
authors.initials: OL
authors.lastname: Holmen
authors.affiliation: HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Forskningsvegen 2, 7600, Levanger, Norway.
authors.forename: Erik R
authors.initials: ER
authors.lastname: Sund
authors.affiliation: HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Forskningsvegen 2, 7600, Levanger, Norway.
authors.forename: Kristian
authors.initials: K
authors.lastname: Midthjell
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D000067329:Obesity, Metabolically Benign / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D013997:Time Factors; D015430:Weight Gain; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents