Well: Keeping Blood Pressure in Check

Since the start of the 21st century, Americans have made great progress in controlling high blood pressure, though it remains a leading cause of heart attacks, strokes, congestive heart failure and kidney disease.

Now 48 percent of the more than 76 million adults with hypertension have it under control, up from 29 percent in 2000.

But that means more than half, including many receiving treatment, have blood pressure that remains too high to be healthy. (A normal blood pressure is lower than 120 over 80.) With a plethora of drugs available to normalize blood pressure, why are so many people still at increased risk of disease, disability and premature death? Hypertension experts offer a few common, and correctable, reasons:

¶ About 20 percent of affected adults don’t know they have high blood pressure, perhaps because they never or rarely see a doctor who checks their pressure.

¶ Of the 80 percent who are aware of their condition, some don’t appreciate how serious it can be and fail to get treated, even when their doctors say they should.

¶ Some who have been treated develop bothersome side effects, causing them to abandon therapy or to use it haphazardly.

¶ Many others do little to change lifestyle factors, like obesity, lack of exercise and a high-salt diet, that can make hypertension harder to control.

Dr. Samuel J. Mann, a hypertension specialist and professor of clinical medicine at Weill-Cornell Medical College, adds another factor that may be the most important. Of the 71 percent of people with hypertension who are currently being treated, too many are taking the wrong drugs or the wrong dosages of the right ones.

Dr. Mann, author of “Hypertension and You: Old Drugs, New Drugs, and the Right Drugs for Your High Blood Pressure,” says that doctors should take into account the underlying causes of each patient’s blood pressure problem and the side effects that may prompt patients to abandon therapy. He has found that when treatment is tailored to the individual, nearly all cases of high blood pressure can be brought and kept under control with available drugs.

Plus, he said in an interview, it can be done with minimal, if any, side effects and at a reasonable cost.

“For most people, no new drugs need to be developed,” Dr. Mann said. “What we need, in terms of medication, is already out there. We just need to use it better.”

But many doctors who are generalists do not understand the “intricacies and nuances” of the dozens of available medications to determine which is appropriate to a certain patient.

“Prescribing the same medication to patient after patient just does not cut it,” Dr. Mann wrote in his book.

The trick to prescribing the best treatment for each patient is to first determine which of three mechanisms, or combination of mechanisms, is responsible for a patient’s hypertension, he said.

¶ Salt-sensitive hypertension, more common in older people and African-Americans, responds well to diuretics and calcium channel blockers.

¶ Hypertension driven by the kidney hormone renin responds best to ACE inhibitors and angiotensin receptor blockers, as well as direct renin inhibitors and beta-blockers.

¶ Neurogenic hypertension is a product of the sympathetic nervous system and is best treated with beta-blockers, alpha-blockers and drugs like clonidine.

According to Dr. Mann, neurogenic hypertension results from repressed emotions. He has found that many patients with it suffered trauma early in life or abuse. They seem calm and content on the surface but continually suppress their distress, he said.

One of Dr. Mann’s patients had had high blood pressure since her late 20s that remained well-controlled by the three drugs her family doctor prescribed. Then in her 40s, periodic checks showed it was often too high. When taking more of the prescribed medication did not result in lasting control, she sought Dr. Mann’s help.

After a thorough work-up, he said she had a textbook case of neurogenic hypertension, was taking too much medication and needed different drugs. Her condition soon became far better managed, with side effects she could easily tolerate, and she no longer feared she would die young of a heart attack or stroke.

But most patients should not have to consult a specialist. They can be well-treated by an internist or family physician who approaches the condition systematically, Dr. Mann said. Patients should be started on low doses of one or more drugs, including a diuretic; the dosage or number of drugs can be slowly increased as needed to achieve a normal pressure.

Specialists, he said, are most useful for treating the 10 percent to 15 percent of patients with so-called resistant hypertension that remains uncontrolled despite treatment with three drugs, including a diuretic, and for those whose treatment is effective but causing distressing side effects.

Hypertension sometimes fails to respond to routine care, he noted, because it results from an underlying medical problem that needs to be addressed.

“Some patients are on a lot of blood pressure drugs — four or five — who probably don’t need so many, and if they do, the question is why,” Dr. Mann said.

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The Lede Blog: Fire at a Nightclub in Southern Brazil

Victims of the fire are attended by medics.

An intense fire ripped through a nightclub crowded with university students in southern Brazil early on Sunday morning, leaving behind a scene of horror, with bodies piled in the club’s bathrooms and on the street.

At least 232 people were killed, many of them students in the agronomy and veterinary medicine programs at a local university, police officials said.

As Simon Romero reports, a flare from a band’s pyrotechnic show ignited the fire in the nightclub, called Kiss, in the southern city of Santa Maria. Rescue workers continued to haul bodies from the still-smoldering building on Sunday.

Amateur videos posted to YouTube showed scenes of chaos as medics scurried over the bodies of victims who appeared to be unconscious, checking for signs of life.

Medics rush to care for victims of the fire.

Officials and witnesses say that security guards at the club had locked some exits, sewing panic as people attempted to flee the flames and smoke.

“Only after a multitude pushed down the security guards did they see the crap they had done,” Murilo de Toledo Tiecher, 26, a medical student who survived the fire, said in comments posted on Facebook.

Shortly before the fire, a club D.J. posted a photo on Facebook from inside the crowded club apparently showing the pyrotechnic display on stage.

A short time later, another photo that was said to be taken outside the club and widely disseminated through social media showed smoke billowing from the front entrance.

BOATE KISS PEGANDO FOGO! http://t.co/tdV2DO4q

— Boatos SM ® #LUTO (@BoatoSM) 27 Jan 13

The fire quickly engulfed the building.

Firefighters and volunteers who used T-shirts to protect themselves from the smoke struggled to pull people from the burning building.

Firefighters and volunteers tried to pull people from the burning building

Photos from the scene showed frantic friends and family members gathered outside the club and a hospital.

As Mr. Romero reports, witnesses said the fire started about 2 a.m. after the band, Gurizada Fandangueira, took the stage. At least one member of the five-person band, which is based in Santa Maria and advertised its use of pyrotechnics, was said to have been killed in the fire.

Overcrowding and a disregard for fire safety codes have led to deadly blazes at nightclubs in the past, though Sunday’s tragedy in Brazil is among the worst.

In 2003 in Rhode Island, also fire set off by a pyrotechnic display at a club killed about 100 people. A fire that erupted under similar circumstances in Russia left almost as many dead in 2009.

And in Luoyang, China in 2000, 309 people were killed in a fire that broke out at a dance hall, forcing some to leap from high-rise windows.

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Unboxed: Literary History, Seen Through Big Data’s Lens

ANY list of the leading novelists of the 19th century, writing in English, would almost surely include Charles Dickens, Thomas Hardy, Herman Melville, Nathaniel Hawthorne and Mark Twain.

But they do not appear at the top of a list of the most influential writers of their time. Instead, a recent study has found, Jane Austen, author of “Pride and Prejudice, “ and Sir Walter Scott, the creator of “Ivanhoe,” had the greatest effect on other authors, in terms of writing style and themes.

These two were “the literary equivalent of Homo erectus, or, if you prefer, Adam and Eve,” Matthew L. Jockers wrote in research published last year. He based his conclusion on an analysis of 3,592 works published from 1780 to 1900. It was a lot of digging, and a computer did it.

The study, which involved statistical parsing and aggregation of thousands of novels, made other striking observations. For example, Austen’s works cluster tightly together in style and theme, while those of George Eliot (a k a Mary Ann Evans) range more broadly, and more closely resemble the patterns of male writers. Using similar criteria, Harriet Beecher Stowe was 20 years ahead of her time, said Mr. Jockers, whose research will soon be published in a book, “Macroanalysis: Digital Methods and Literary History” (University of Illinois Press).

These findings are hardly the last word. At this stage, this kind of digital analysis is mostly an intriguing sign that Big Data technology is steadily pushing beyond the Internet industry and scientific research into seemingly foreign fields like the social sciences and the humanities. The new tools of discovery provide a fresh look at culture, much as the microscope gave us a closer look at the subtleties of life and the telescope opened the way to faraway galaxies.

“Traditionally, literary history was done by studying a relative handful of texts,” says Mr. Jockers, an assistant professor of English and a researcher at the Center for Digital Research in the Humanities at the University of Nebraska. “What this technology does is let you see the big picture — the context in which a writer worked — on a scale we’ve never seen before.”

Mr. Jockers, 46, personifies the digital advance in the humanities. He received a Ph.D. in English literature from Southern Illinois University, but was also fascinated by computing and became a self-taught programmer. Before he moved to the University of Nebraska last year, he spent more than a decade at Stanford, where he was a founder of the Stanford Literary Lab, which is dedicated to the digital exploration of books.

Today, Mr. Jockers describes the tools of his trade in terms familiar to an Internet software engineer — algorithms that use machine learning and network analysis techniques. His mathematical models are tailored to identify word patterns and thematic elements in written text. The number and strength of links among novels determine influence, much the way Google ranks Web sites.

It is this ability to collect, measure and analyze data for meaningful insights that is the promise of Big Data technology. In the humanities and social sciences, the flood of new data comes from many sources including books scanned into digital form, Web sites, blog posts and social network communications.

Data-centric specialties are growing fast, giving rise to a new vocabulary. In political science, this quantitative analysis is called political methodology. In history, there is cliometrics, which applies econometrics to history. In literature, stylometry is the study of an author’s writing style, and these days it leans heavily on computing and statistical analysis. Culturomics is the umbrella term used to describe rigorous quantitative inquiries in the social sciences and humanities.

“Some call it computer science and some call it statistics, but the essence is that these algorithmic methods are increasingly part of every discipline now,” says Gary King, director of the Institute for Quantitative Social Science at Harvard.

Cultural data analysts often adapt biological analogies to describe their work. Mr. Jockers, for example, called his research presentation “Computing and Visualizing the 19th-Century Literary Genome.”

Such biological metaphors seem apt, because much of the research is a quantitative examination of words. Just as genes are the fundamental building blocks of biology, words are the raw material of ideas.

“What is critical and distinctive to human evolution is ideas, and how they evolve,” says Jean-Baptiste Michel, a postdoctoral fellow at Harvard.

Mr. Michel and another researcher, Erez Lieberman Aiden, led a project to mine the virtual book depository known as Google Books and to track the use of words over time, compare related words and even graph them.

Google cooperated and built the software for making graphs open to the public. The initial version of Google’s cultural exploration site began at the end of 2010, based on more than five million books, dating from 1500. By now, Google has scanned 20 million books, and the site is used 50 times a minute. For example, type in “women” in comparison to “men,” and you see that for centuries the number of references to men dwarfed those for women. The crossover came in 1985, with women ahead ever since.

In work published in Science magazine in 2011, Mr. Michel and the research team tapped the Google Books data to find how quickly the past fades from books. For instance, references to “1880,” which peaked in that year, fell to half by 1912, a lag of 32 years. By contrast, “1973” declined to half its peak by 1983, only 10 years later. “We are forgetting our past faster with each passing year,” the authors wrote.

JON KLEINBERG, a computer scientist at Cornell, and a group of researchers approached collective memory from a very different perspective.

This article has been revised to reflect the following correction:

Correction: January 27, 2013

An earlier version of this article misstated Matthew L. Jockers’s age. He is 46, not 48. 

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J. Richard Hackman, an Expert in Team Dynamics, Dies at 72

J. Richard Hackman, a Harvard psychology professor whose fieldwork sometimes took him to the cockpit of an airliner to observe the crew in a nearly five-decade quest to determine the dynamics of teamwork and effective leadership, died on Jan. 8 in Boston. He was 72.

The cause was lung cancer, his wife, Judith Dozier Hackman, said.

Dr. Hackman, the author or co-author of 10 books on group dynamics, was the Edgar Pierce professor of social and organizational psychology at Harvard.

In one of his best-known books, “Leading Teams: Setting the Stage for Great Performances” (2002), he replaced the popular image of the powerful “I can do it all” team leader with that of someone who, as he wrote, had the subtle skills “to get a team established on a good trajectory, and then to make small adjustments along the way to help members succeed.”

The conditions for a successful team effort — among them “a compelling direction, an enabling team structure, a supportive organizational context and expert team coaching” — “are easy to remember,” Dr. Hackman wrote.

“The challenge,” he continued, “comes in developing an understanding of those conditions that is deep and nuanced enough to be useful in guiding action, and in devising strategies for creating them even in demanding or team-unfriendly organizational circumstances.”

Besides tracking the interplay of pilots, co-pilots and navigators aboard civilian and military planes, Dr. Hackman observed corporate boards, sports teams, orchestra players, telephone-line repair crews, hospital workers and restaurant kitchen staff members.

And in recent years, for his 2011 book, “Collaborative Intelligence,” he was allowed to observe interactions within the American intelligence, defense, law-enforcement and crisis-management communities.

“Although my main aspiration has been to provide guidance that will be useful to team leaders and members,” he wrote, “there are no ‘one-minute’ prescriptions here — creating, leading and serving on teams is not that simple.”

Anita Woolley, a professor of organizational behavior and theory at the Tepper School of Business at Carnegie Mellon University in Pittsburgh, said, “The key thing about Dr. Hackman’s work is that it stands in contrast to some of the more popular models of leadership that focused very much on style or how leaders behave, versus what they do.”

Rather than viewing pay as a prime motivator for good performance, she continued, “he focused on features of people’s jobs that made them more intrinsically satisfied: the freedom to determine how they conduct their work, having a variety of tasks, having knowledge of the ultimate outcomes of their work, knowing how their work affects or is received by other people.”

He also liked to overturn some of the received wisdom about teamwork. In a 2011 article for The Harvard Business Review, Dr. Hackman listed “Six Common Misperceptions About Teamwork.” Among them was this:

“Misperception No. 2: It’s good to mix it up. New members bring energy and fresh ideas to a team. Without them, members risk becoming complacent, inattentive to changes in the environment, and too forgiving of fellow members’ misbehavior.

“Actually: The longer members stay together as an intact group, the better they do. As unreasonable as this may seem, the research evidence is unambiguous. Whether it is a basketball team or a string quartet, teams that stay together longer play together better.”

John Richard Hackman was born in Joliet, Ill., on June 14, 1940, the only child of J. Edward and Helen Hackman. His father was an oil pipeline engineer, his mother a schoolteacher.

Dr. Hackman received a bachelor’s degree in mathematics from MacMurray College in Jacksonville, Ill., in 1962, and a doctorate in psychology from the University of Illinois in 1966. He soon joined the psychology and administrative sciences department faculties at Yale, where he taught until 1986, when he moved to the psychology and business departments at Harvard.

Besides his wife, who is an associate dean at Yale, he is survived by two daughters, Julia Beth Proffitt and Laura Dianne Codeanne, and four grandchildren.

After Dr. Hackman died, The Harvard Crimson wrote that for years he had “devoted countless hours to improving one team in particular — the Harvard women’s basketball squad, for which he volunteered as an honorary coach.”

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Well: Ask Well: Squats for Aging Knees

You are already doing many things right, in terms of taking care of your aging knees. In particular, it sounds as if you are keeping your weight under control. Carrying extra pounds undoubtedly strains knees and contributes to pain and eventually arthritis.

You mention weight training, too, which is also valuable. Sturdy leg muscles, particularly those at the front and back of the thighs, stabilize the knee, says Joseph Hart, an assistant professor of kinesiology and certified athletic trainer at the University of Virginia, who often works with patients with knee pain.

An easy exercise to target those muscles is the squat. Although many of us have heard that squats harm knees, the exercise is actually “quite good for the knees, if you do the squats correctly,” Dr. Hart says. Simply stand with your legs shoulder-width apart and bend your legs until your thighs are almost, but not completely, parallel to the ground. Keep your upper body straight. Don’t bend forward, he says, since that movement can strain the knees. Try to complete 20 squats, using no weight at first. When that becomes easy, Dr. Hart suggests, hold a barbell with weights attached. Or simply clutch a full milk carton, which is my cheapskate’s squats routine.

Straight leg lifts are also useful for knee health. Sit on the floor with your back straight and one leg extended and the other bent toward your chest. In this position, lift the straight leg slightly off the ground and hold for 10 seconds. Repeat 10 to 20 times and then switch legs.

You can also find other exercises that target the knees in this video, “Increasing Knee Stability.”

Of course, before starting any exercise program, consult a physician, especially, Dr. Hart says, if your knees often ache, feel stiff or emit a strange, clicking noise, which could be symptoms of arthritis.

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Well: Ask Well: Squats for Aging Knees

You are already doing many things right, in terms of taking care of your aging knees. In particular, it sounds as if you are keeping your weight under control. Carrying extra pounds undoubtedly strains knees and contributes to pain and eventually arthritis.

You mention weight training, too, which is also valuable. Sturdy leg muscles, particularly those at the front and back of the thighs, stabilize the knee, says Joseph Hart, an assistant professor of kinesiology and certified athletic trainer at the University of Virginia, who often works with patients with knee pain.

An easy exercise to target those muscles is the squat. Although many of us have heard that squats harm knees, the exercise is actually “quite good for the knees, if you do the squats correctly,” Dr. Hart says. Simply stand with your legs shoulder-width apart and bend your legs until your thighs are almost, but not completely, parallel to the ground. Keep your upper body straight. Don’t bend forward, he says, since that movement can strain the knees. Try to complete 20 squats, using no weight at first. When that becomes easy, Dr. Hart suggests, hold a barbell with weights attached. Or simply clutch a full milk carton, which is my cheapskate’s squats routine.

Straight leg lifts are also useful for knee health. Sit on the floor with your back straight and one leg extended and the other bent toward your chest. In this position, lift the straight leg slightly off the ground and hold for 10 seconds. Repeat 10 to 20 times and then switch legs.

You can also find other exercises that target the knees in this video, “Increasing Knee Stability.”

Of course, before starting any exercise program, consult a physician, especially, Dr. Hart says, if your knees often ache, feel stiff or emit a strange, clicking noise, which could be symptoms of arthritis.

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At Least 30 Die in Egyptian Riots After Soccer Verdict

Tara Todras-Whitehill for The New York Times

A protester threw a tear-gas canister back toward police officers in Cairo on Saturday. More Photos »

CAIRO — The Egyptian government appeared to have lost control of the major city of Port Said on Saturday after a court sentenced 21 fans to death for their role in a deadly soccer riot, and their supporters attacked the prison where they were being held, as well as the police and court buildings.

By evening, fighting in the streets of Port Said had left at least 30 people dead, mostly from gunfire, and injured more than 300. Fearful residents stayed in their homes. Doctors in the city said the local hospital was overloaded with casualties and pleaded for help. Water had run out in some places. Rioters attacked the Port Said power plant, and for a time closed off the main roads to the city.

A spokesman for the Interior Ministry acknowledged that its security forces were unable to control the violence and urged political leaders to try to broker a peace agreement. President Mohamed Morsi met with the National Defense Council, which includes the nation’s top military leaders, and the information minister announced that the council was considering imposing a curfew and state of emergency.

By 8 p.m., a spokesman for the Egyptian military said its troops had moved in and secured vital facilities, including the prison, the Mediterranean port and the Suez Canal. But in telephone interviews, residents said the streets remained lawless. “I’m worried for my sister and mother,” said Ahmed Zangir. “I could run or do something, but it is not safe for them to get out.”

Mr. Zangir added: “Thugs are abusing the opportunity. They are everywhere.”

The violence that engulfed Port Said may be the sharpest challenge yet to Egypt’s new Islamist rulers as they try to re-establish public order after the two years of turmoil that have followed the end of Hosni Mubarak’s brutal autocracy.

The uprising in support of the soccer fans sentenced to death coincided with the third day of clashes between protesters and the police in Cairo and in other cities around the country, which were set off by the second anniversary of the revolt against Mr. Mubarak. Those battles were more isolated, typically confined to clashes around symbols of government power, like the Interior Ministry headquarters in Cairo or the headquarters of the provincial government in Suez.

But by Saturday night, those clashes had killed more than a dozen people, including nine in Suez on Friday, state media reported.

The anniversary battles were fueled by a combination of frustration with the meager rewards of the revolution so far and hostility toward the new Islamist leaders. But the escalating chaos in Port Said arising from the soccer riot verdict posed a far greater challenge to those leaders and their promises to enforce the rule of law.

It was unclear how the fledgling government might rein in the mob without either a brutal crackdown or a capitulation to its demands. And either alternative could further inflame the streets in Cairo and around Egypt.

“The solution isn’t a security solution,” Gen. Osama Ismail, a spokesman for the Interior Ministry, said in a television interview. “We urge the political and patriotic leaders and forces to intervene to calm the situation.”

The case that set off the riot grew out of a deadly brawl last February between rival groups of hard-core fans of soccer teams from Cairo and Port Said at a match in Port Said, which has a population of about 600,000. The hard-core fans, called Ultras, are known for their appetite for violence against rival teams or the police. Some had smuggled knives and other weapons into the stadium, security officials said at the time.

Seventy-four people were killed and over 1,000 injured in the soccer riot. Many died after being trampled under the stampeding crowds or falling from stadium balconies, according to forensic testimony later reported in the state media.

It was the worst soccer riot in Egyptian history and among the worst in the world. Many political figures, including members of the Mr. Morsi’s Muslim Brotherhood, initially sought to blame a conspiracy orchestrated by Mubarak loyalists or the Interior Ministry.

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Gadgetwise Blog: Is January the Time to Buy Electronics?

At the International Consumer Electronics Show in Las Vegas in early January, manufacturers tantalized consumers with new electronics soon to hit the shelves. But what does that do to the prices of current models that are being replaced? Is this a golden buying opportunity?

Yes and no. Yes for TVs, no for laptops. I’ll explain.

Decide.com, which tracks the price of electronics, studied what happened to the cost of TVs and laptops in past years after C.E.S.

What it found is that TV prices dip to near yearly lows after the show, matching holiday prices. With the average price of the top 250 TVs at $1,057, the post-show average is projected to drop an average of $211, to $846, based on data from previous  years. That is a 20 percent savings.

Laptops don’t drop so steeply. After the show, the 100 most popular laptops have historically been discounted 8 percent. This year that would mean the top 100 laptops, which average $780 in price, would be reduced $62, to $718.

Laptop price are lowest in late June through early July, right before the back to school sales, and during the last two weeks of September, after those sales, according to Decide.com’s data. At those times the discounts are typically 10 percent.

Of course, averages can be deceiving. Prices are volatile all year around, so a particular TV or computer you want could be discounted far more at any time.

There are a number of browser add-ons and apps that let you track prices of individual products, or you can use Decide.com – but it will cost you. Membership is $5 a month or $30 a year for full access.

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Labor Relations Board Rulings Could Be Undone

By ruling that Mr. Obama’s three recess appointments last January were illegal, the federal appeals court ruling, if upheld, would leave the board with just one member, short of the quorum needed to issue any rulings. The Obama administration could appeal the court ruling, but no announcement was made on Friday.

If the Supreme Court were to uphold Friday’s ruling, issued by the United States Court of Appeals for the District of Columbia Circuit, it would mean that the labor board did not have a quorum since last January and that all its rulings since then should be nullified.

Many Republicans and business groups applauded Friday’s ruling. They often assert that the appointments Mr. Obama made to the board have transformed it into a tool of organized labor. But many Democrats and labor unions say Mr. Obama’s appointments restored ideological balance to the board after it was tipped in favor of business interests under President George W. Bush

Mark G. Pearce, the board’s chairman, issued a statement saying the board disagreed with the ruling and suggested that other appeals courts hearing cases about the constitutionality of Mr. Obama’s appointments could reach a different conclusion.

“In the meantime, the board has important work to do,” said Mr. Pearce, whose agency oversees enforcement of the laws governing strikes and unionization drives. “We will continue to perform our statutory duties and issue decisions.”

Unless the Senate confirms future nominees to the board — Senate Republicans have blocked several of Mr. Obama’s board nominees — Mr. Pearce will be the only member left if Friday’s ruling is upheld. The board has five seats.

Representative Darrell Issa, a California Republican who is the chairman of the Oversight and Government Reform Committee, issued a statement that urged the recess appointees to “do the right thing and step down.” He added, “To avoid further damage to the economy, the N.L.R.B. must take the responsible course and cease issuing any further opinions until a constitutionally sound quorum can be established.”

The three disputed recess appointees included two Democrats, Sharon Block, deputy labor secretary, and Richard Griffin, general counsel to the operating engineers’ union; and one Republican, Terence Flynn, a counsel to a board member. Mr. Flynn resigned last May after being accused of leaking materials about the group’s deliberations. Another Republican member, Brian Hayes, stepped down when his term expired last month.

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40 Years After Roe v. Wade, Thousands March to Oppose Abortion

Drew Angerer/The New York Times

Pro-life activists made their way down Constitution Avenue toward the Supreme Court during the March for Life in Washington on Friday.

WASHINGTON — Three days after the 40th anniversary of the decision in Roe v. Wade, the landmark Supreme Court case that legalized abortion, tens of thousands of abortion opponents from around the country came to the National Mall on Friday for the annual March for Life rally, which culminated in a demonstration in front of the Supreme Court building.

On a gray morning when the temperature was well below freezing, the crowd pressed in close against the stage to hear more than a dozen speakers, who included Tony Perkins, the president of the Family Research Council; Representative Diane Black, Republican of Tennessee, who recently introduced legislation to withhold financing from Planned Parenthood, and Senator Rand Paul, Republican of Kentucky; Cardinal Seán Patrick O’Malley of Boston; and Rick Santorum, the former senator from Pennsylvania and Republican presidential candidate.

Mr. Santorum spoke of his wife’s decision not to have an abortion after they learned that their child — their daughter Bella, now 4 — had a rare genetic disorder called Trisomy 18.

“We all know that death is never better, never better,” Mr. Santorum said. “Bella is better for us, and we are better because of Bella.”

Jeanne Monahan, the president of the March for Life Education and Defense Fund, said that the march was both somber and hopeful.

“We’ve lost 55 million Americans to abortion,” she said. “At the same time, I think we’re starting to win. We’re winning in the court of public opinion, we’re winning in the states with legislation.”

Though the main event officially started at noon, the day began much earlier for the participants, with groups in matching scarves engaged in excited chatter on the subway and gaggles of schoolchildren wearing name tags around their necks. Arriving on the Mall, attendees were greeted with free signs (“Defund Planned Parenthood” and “Personhood for Everyone”) and a man barking into a megaphone, “Ireland is on the brink of legalizing abortion, which is not good.”

The march came two months after the 2012 campaign season, in which social issues like abortion largely took a back seat to the focus on the economy. But the issue did come up in Congressional races in which Republican candidates made controversial statements about rape or abortion. In Indiana, Richard E. Mourdock, a Republican candidate for the Senate, said in a debate that he believed that pregnancies resulting from rape were something that “God intended,” and in Illinois, Representative Joe Walsh said in a debate that abortion was never necessary to save the life of the mother because of “advances in science and technology.” Both men lost, hurt by a backlash from female voters.

Recent polls show that while a majority of Americans do not want Roe v. Wade to be overturned entirely, many favor some restrictions. In a Gallup poll released this week, 52 percent of those surveyed said that abortions should be legal only under certain circumstances, while 28 percent said they should be legal under all circumstances, and 18 percent said they should be illegal under all circumstances. In a Pew poll this month, 63 percent of respondents said they did not want Roe v. Wade to be overturned completely, and 29 percent said they did — views largely consistent with surveys taken over the past two decades.

“Most Americans want some restrictions on abortion,” Ms. Monahan said. “We see abortion as the human rights abuse of today.”

Speaker John A. Boehner of Ohio, who spoke via a recorded video, called on the protest group, particularly the young people, to make abortion “a relic of the past.”

“Human life is not an economic or political commodity, and no government on earth has the right to treat it that way,” he said.

The crowd was dotted with large banners, many bearing the names of the attendees’ home states and churches and colleges. Gary Storey, 36, stood holding a handmade sign that read “I was adopted. Thanks Mom for my life.” Next to him stood his adoptive mother, Ellen Storey, 66, who held her own handmade sign with a picture of her six children and the words “To the mothers of our four adopted children, ‘Thank You’ for their lives.”

Mr. Storey said he was grateful for the decision by his biological mother to carry through with her pregnancy. “Beats the alternative,” he joked.

Last week, the Planned Parenthood Federation of America started a new Web site, and on Tuesday, its president, Cecile Richards, released a statement supporting abortion rights.

“Planned Parenthood understands that abortion is a deeply personal and often complex decision for a woman to consider, if and when she needs it,” she said. “A woman should have accurate information about all of her options around her pregnancy. To protect her health and the health of her family, a woman must have access to safe, legal abortion without interference from politicians, as protected by the Supreme Court for the last 40 years.”

This article has been revised to reflect the following correction:

Correction: January 25, 2013

A summary that appeared on the home page of NYTimes.com with an earlier version of this article misstated the day of the march. It took place on Friday, not Thursday.

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