May 27, 2015
TAKE-HOME MESSAGE
- The investigators of this study of 26,875 individuals, aged ≥45 years and either black or white, assessed incident stroke events and their association with systolic blood pressure. Patients were categorized by systolic blood pressure (SBP) and number of antihypertensive medications. There were 4 classes of blood pressure: normal (<120 mm Hg), prehypertension (SBP, 120–139 mm Hg), stage 1 hypertension (140–159 mm Hg), and stage 2 hypertension (≥160 mm Hg); and 4 classes for medication use: 0, 1, 2, and ≥3. In the 6.3 years of follow-up, 823 stroke events occurred, and 46% were in individuals with successfully treated hypertension (SBP, <140 mm Hg). Within the blood pressure classes, the risk for stroke increased with each addition to the antihypertensive medications regimen required. A successfully treated hypertensive individual (SBP <120 mm Hg) using ≥3 medication classes had a marginally higher stroke risk than an individual with untreated stage 1 hypertension.
- Even with successful pharmacological treatment of hypertension, there is increased risk for stroke, as nearly half of the population treated to guideline (SBP <140 mm Hg) failed to return to risk levels similar to those in normotensive individuals.
Abstract
BACKGROUND AND PURPOSE
Although pharmacological treatment of hypertension has important health benefits, it does not capture the benefit of maintenance of ideal health through the prevention or delay of hypertension.
METHODS
A total of 26 875 black and white participants aged 45+ years were assessed and followed for incident stroke events. The association was assessed between incident stroke and: (1) systolic blood pressure (SBP)categorized as normal (
RESULTS
During 6.3 years of follow-up, 823 stroke events occurred. Nearly half (46%) of the population were successfully treated (SBP
CONCLUSIONS
Maintaining the normotensive status solely through pharmacological treatment has a profound impact, as nearly half of this general population cohort were treated to guideline (SBP