March 27, 1981
View Full PaperSystolic blood pressure, arterial rigidity, and risk of stroke. The Framingham study
Key Result
Subjects with isolated systolic hypertension experienced two to four times as many strokes as normotensive persons, independent of arterial rigidity.
Study Design
Type
Cohort
Structured PICO
Does isolated systolic hypertension increase the risk of stroke compared to normotension in subjects from the Framingham study?
P
Population
Subjects from the Framingham study
I
Intervention
Isolated systolic hypertension
C
Comparator
Normotensive persons
O
Outcome
Future stroke incidencehard clinical
Isolated systolic hypertension is an independent risk factor for stroke, increasing the risk two to four times compared to normotension.
Main Result
Effect estimate: 2-4x risk
Abstract
Based on prospective data from the Framingham study relating systolic pressure, diastolic pressure, age, and pulse-wave configuration to future stroke incidence, it would appear that isolated systolic hypertension predisposes to stroke independent of arterial rigidity. The prevalence of isolated systolic hypertension increased with age and with the degree of blunting of the dicrotic notch in the pulse wave. Subjects with isolated systolic hypertension experienced two to four times as many strokes as did normotensive persons. While diastolic pressure is related to stroke incidence, in the subject with systolic hypertension, the diastolic component adds little to risk assessment and in men, in this subgroup, appears unrelated to stroke incidence. (JAMA1981;245:1225-1229)