Key result
Systolic blood pressure from home measurements showed the strongest association with total and ischemic stroke (P<0.01), whereas pulse pressure was weakly associated.
Why the study?
Which home blood pressure indices are most strongly associated with stroke risk in adults without a history of stroke?
Cohort (n=2,369)
Which home blood pressure indices are most strongly associated with stroke risk in adults without a history of stroke?
p-value: p=<0.01
Systolic blood pressure obtained from home measurements shows the strongest association with stroke risk compared to other blood pressure indices.
Home SBP monitoring may refine primary-prevention stroke risk estimates; leaves open whether it outperforms other indices for event reduction.
BACKGROUND AND PURPOSE: The purpose of this prospective cohort study was to investigate associations between stroke and blood pressure (BP) indices (systolic BP [SBP], diastolic BP [DBP], mean BP, and pulse pressure [PP]) determined by home BP measurement. METHODS: Associations between stroke and BP indices were examined in a rural Japanese population. Home BP data of 2369 subjects (40% men) > or =35 years of age (mean, 59 years) without a history of stroke were obtained. Associations between stroke and each index were determined using Cox proportional hazards regression and the likelihood ratio (LR) test. RESULTS: During follow-up (mean, 11.7 years), 238 strokes occurred. The LR test showed that SBP and mean BP were significantly more strongly associated with total and ischemic stroke than DBP and PP (LR chi2 > or =9.3, P<0.01 for SBP/mean BP, LR chi2 < or =3.8, P> or =0.05 for DBP/PP). SBP tended to be more strongly associated with total/ischemic stroke than mean BP (LR chi2=3.8, P=0.05 for SBP, LR chi2 < or =0.2, P>0.6 for mean BP). PP tended to be slightly more strongly associated with ischemic stroke than DBP (LR chi2=7.5, P<0.01 for DBP, LR chi(2)=9.3, P<0.01 for PP), whereas DBP was significantly more strongly associated with hemorrhagic stroke than PP (LR chi2=9.2, P<0.01 for DBP, LR chi2=2.5, P=0.01 for PP). CONCLUSIONS: PP obtained from home BP measurements was weakly associated with stroke, whereas SBP showed the strongest association. Additionally, DBP and PP may be associated with different stroke types.
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Inoue et al. (2009) conducted a cohort in Stroke (n=2,369). Home blood pressure indices (SBP, DBP, mean BP, PP) was evaluated on Stroke (p=<0.01). Systolic blood pressure from home measurements showed the strongest association with total and ischemic stroke (P<0.01), whereas pulse pressure was weakly associated.
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