Blood Pressure Control and Risk of Stroke

Abstract

Background and Purpose-Adequate control of blood pressure (BP) is a cornerstone in stroke prevention. This study explored the risk of stroke in relation to the quality of BP control in a population-based cohort and whether control of hypertension was related to background characteristics of patients. Methods-A total of 27 936 subjects (10 953 men and 16 983 women), 45 to 73 years old, living in Malmö, Sweden participated in the study. Incidence of stroke was followed-up for a mean period of 6 years. Controlled BP was defined as BP Ͻ140/90 mm Hg in subjects with pharmacological treatment for hypertension. Results-In the whole cohort, 16 648 subjects (60%) had hypertension (BP Ն140/90 mm Hg) and 23% of them received treatment. Among treated hypertensives, 88.2% had BP levels Ն140/90 mm Hg and 49.5% had BP levels Ն160/ 100 mm Hg. During the follow-up, 137 strokes occurred among treated hypertensive subjects. The crude incidence of stroke was 289/100 000 person-year in controlled hypertensive subjects and 705/100 000 person-year in treated hypertensive subjects with BP Ն140/90 mm Hg. It was estimated that Ϸ45% of all strokes among subjects with treatment for hypertension might be attributed to uncontrolled BP. In treated hypertensives, the risk of stroke increased significantly with advancing age, current smoking, high level of diastolic BP, and diabetes. In hypertensive subjects without treatment (nϭ12 819), incidence of stroke was 363/100 000 person-year. Conclusion-Uncontrolled BP is highly prevalent in patients with pharmacological treatment for hypertension. More than 90% of stroke in this group occurred in those with uncontrolled BP. Adequate hypertension control may prevent a substantial proportion of first-ever stroke among treated hypertensives.

Sex differences in the relationships between BMI, WHR and incidence of cardiovascular disease: a population-based cohort study

“…10 Subjects were categorized into current smokers or non-smokers. Alcohol intake was assessed by a diet method previously described in detail 11 and categorized according to daily consumption.…”

Early Inhibition of MMP Activity in Ischemic Rat Brain Promotes Expression of Tight Junction Proteins and Angiogenesis During Recovery

“…We have chosen spontaneously hypertensive rats because they have clinically relevant risk factors for ischemic stroke. 11 We used immunohistochemistry (IHC), western blot, confocal microscopy, and dynamic contrast-enhanced magnetic resonance imaging (MRI) to characterize the role of pericytes, astrocytes, and endothelial cells in the remodeling of TJPs and BBB integration. We determined the spatiotemporal involvement of MMP-2 and -3 in the remodeling of TJPs in the BBB and migration of new vessels.…”

The therapeutic importance of home blood pressure assessment and combination antihypertensive therapy for achieving target blood pressure control: Ibaraki hypertension assessment trial

“…22 The stroma study demonstrated that among the treated hypertensive patients, 11.8% did not reach the target BP (o140/90 mm Hg), and 67% had monotherapy. 23 There was a significant correlation between the number of antihypertensives prescribed and the efficacy of lowering BP. 24 In the I-HAT study, a combination of more than two antihypertensive drugs was prescribed in more than 60% of hypertensive patients to achieve the target office Ibaraki Hypertension Assessment Trial (I-HAT) studyBP.…”