Hypertension increased stroke risk by approximately twofold overall, with a stronger association for hemorrhagic stroke (OR = 2.1) and in women (HR = 1.5).
Does hypertension increase the risk of stroke, and does blood pressure reduction prevent stroke incidence and recurrence?
Hypertension approximately doubles the risk of stroke, while targeted blood pressure reduction significantly decreases both primary and secondary stroke incidence, reinforcing the critical need for intensive BP control.
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Despite strong evidence linking hypertension (HTN) to stroke, updated syntheses are needed to refine risk estimates by stroke subtype and population group. This systematic review quantified HTN-associated stroke risk and examined variations across subtypes. Across 24 studies (n = 1.8 million), HTN increased overall stroke risk by approximately twofold (odds ratio (OR)/hazard ratio (HR)/risk ratio (RR): 1.3-2.1), with the strongest association observed for hemorrhagic stroke (OR = 2.1) and among Asian populations (RR = 2.0). Women had a higher risk (HR = 1.5) than men (HR = 1.3). Each 5-mmHg reduction in systolic blood pressure (SBP) lowered stroke risk by 22% (RR = 0.78), while intensive control (SBP < 120 mmHg) reduced incidence by 41% among people with diabetes. Post-stroke BP management (SBP < 140 mmHg) decreased recurrence by 35% (HR = 0.65). Considerable heterogeneity (I² = 93.2%) was attributed to variations in HTN definitions and population characteristics. Overall, HTN remains a potent and modifiable stroke risk factor, with differential effects by subtype and sex. Intensive and targeted BP control, particularly in high-risk groups, significantly reduces stroke burden. Standardized methods and tailored interventions are needed to address heterogeneity and optimize prevention strategies.
Mohammad et al. (Mon,) reported a other. Hypertension increased stroke risk by approximately twofold overall, with a stronger association for hemorrhagic stroke (OR = 2.1) and in women (HR = 1.5).