May 14, 1:52 PM EDT

*Blood Pressure Rising Around the Globe*

By LAURAN NEERGAARD
AP Medical Writer

WASHINGTON (AP) -- The numbers are a shock: Almost 1 billion people
worldwide have high blood pressure, and over half a billion more will
harbor this silent killer by 2025.

It's not just a problem for the ever-fattening Western world. Even in
parts of Africa, high blood pressure is becoming common.

That translates into millions of deaths from heart disease alone. Yet
hypertension doesn't command the attention of, say, bird flu, which so
far has killed fewer than 200 people.

"Hypertension has gone a bit out of fashion," says Dr. Jan Ostergren of
Sweden's Karolinska University Hospital, who co-authored a
first-of-its-kind analysis of the global impact of high blood pressure.

The idea: to rev up world governments to fight bad blood pressure just
as countries have banded together in the past to fight infectious diseases.

International heart specialists welcome the push.

"Even in the U.S., the majority of people with high blood pressure are
not treated adequately," says Dr. Sidney Smith of the University of
North Carolina at Chapel Hill, who advises the World Heart Federation.
"Look at China, look at Africa, go around the world. It is a major risk
factor."

And the dangers go well beyond the heart. High blood pressure is a
leading cause of strokes and kidney failure. It also plays a role in
blindness and even dementia.

Patients seldom notice symptoms until organs already have been damaged.

Yet treating high blood pressure before that happens is a medical
best-buy. Improving diet and exercise can help. When that's not enough,
blood pressure drugs are among the oldest and thus cheapest on the
market - 21 cents a day for a leading diuretic.

Ostergren joined experts from the London School of Economics and the
State University of New York to assemble two teams of specialists and
map what they call the coming crisis of hypertension: 1.56 billion
people are expected to have it by 2025.

With funding from drug maker Novartis Pharma AG, they're providing
copies to governments and health officials around the globe; a briefing
in Washington is set for Thursday.

The report essentially calls for a cultural change. Consider: In the
U.S., commiserating over blood pressure readings is an accepted
dinner-table topic. Because black Americans are at especially high risk
- roughly 40 percent are affected - hypertension has become a sermon
topic at majority-black churches, and post-service screenings aren't
uncommon. The government even advertises about the condition.

That adds up to an openness about blood pressure not seen in much of the
world, says report co-author Dr. Michael Weber of SUNY's Downstate
College of Medicine.

In some regions, "it's sort of an insult to your manhood if you have to
take a blood-pressure medicine," Weber says, citing estimates that
hypertension affects about one in three adults in Mexico, Paraguay and
Venezuela.

"We need to break those barriers as well and make it perfectly
fashionable. We need to get role models in those countries to say, 'You
know what? I've got high blood pressure.'"

The U.S. still needs to improve, too, Weber hastens to add. High blood
pressure affects nearly one in three adult Americans as well, or 72
million people. About a third have their condition well-controlled, not
nearly enough but better than other countries that track treatment, the
report found.

Normal blood pressure is measured at less than 120 over 80. Anyone can
get high blood pressure, a level of 140 over 90 or more. But being
overweight and inactive, and eating too much salt, all increase the
risk. So does getting older.

The world's population is aging and fattening, fueling a continued
increase in blood pressure problems. Remarkably, the report cites worse
hypertension rates in much of Western Europe than in the U.S., despite
cultural similarities: 38 percent in England, Sweden and Italy; 45
percent in Spain; 55 percent in Germany.

But the biggest jump is expected in developing countries and nations
rapidly moving to more Western-style economies, the report warns. In
parts of India, studies suggest one in three urban adults has high blood
pressure, while it's still rare in rural areas with more traditional
lifestyles. More than a quarter of adults in China have hypertension. So
do one in four in Ghana and South Africa.

Treatment is difficult, because patients often quit their medicine, not
understanding it's necessary even when they feel good. Also, doctors may
be reluctant to prescribe the two- or three-drug combinations that half
of patients wind up needing.

For poorer countries, the tab for even low-cost diuretics is an issue -
not to mention public education about sticking to treatment, notes
Smith, the World Heart Federation adviser, who was not involved in the
new report.

But fighting bad blood pressure could mean that developing countries
avoid epidemics of full-blown heart disease, which they definitely can't
afford, Smith stresses. World health and economic groups already are
brainstorming strategies to help, such as whether industries that move
into poor countries should be required to screen their workers for high
blood pressure.

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EDITOR'S NOTE - Lauran Neergaard covers health and medical issues for
The Associated Press in Washington.