Does Blood Pressure Inevitably Rise With Age?: Longitudinal Evidence Among Forager-Horticulturalists

Hypertension. 2012 Jul;60(1):25-33. doi: 10.1161/HYPERTENSIONAHA.111.189100. Epub 2012 May 21.

Abstract

The rise in blood pressure with age is a major risk factor for cardiovascular and renal disease, stroke, and type 2 diabetes mellitus. Age-related increases in blood pressure have been observed in almost every population, except among hunter-gatherers, farmers, and pastoralists. Here we tested for age-related increases in blood pressure among Tsimane forager-farmers. We also test whether lifestyle changes associated with modernization lead to higher blood pressure and a greater rate of age-related increase in blood pressure. We measured blood pressure longitudinally on 2248 adults age ≥ 20 years (n=6468 observations over 8 years). Prevalence of hypertension was 3.9% for women and 5.2% for men, although diagnosis of persistent hypertension based on multiple observations reduced prevalence to 2.9% for both sexes. Mixed-effects models revealed systolic, diastolic, and pulse blood pressure increases of 2.86 (P<0.001), 0.95 (P<0.001), and 1.95 mmHg (P<0.001) per decade for women and 0.91 (P<0.001), 0.93 (P<0.001), and -0.02 mmHg (P=0.93) for men, substantially lower than rates found elsewhere. Lifestyle factors, such as smoking and Spanish fluency, had minimal effect on mean blood pressure and no effect on age-related increases in blood pressure. Greater town proximity was associated with a lower age-related increase in pulse pressure. Effects of modernization were, therefore, deemed minimal among Tsimane, in light of their lean physique, active lifestyle, and protective diet.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging / physiology*
  • Agriculture*
  • Blood Pressure / physiology*
  • Bolivia / epidemiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / diagnosis
  • Hypertension / ethnology
  • Indians, South American*
  • Life Style
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Occupations
  • Prevalence
  • Risk Assessment / statistics & numerical data
  • Sex Factors
  • Social Change
  • Young Adult