Key result
Baseline prehypertension was associated with a significantly increased risk of incident stroke (RR 1.55; 95% CI 1.35-1.79; p < 0.001), largely driven by higher values within the prehypertensive range.
Why the study?
Does baseline prehypertension increase the risk of incident stroke?
Meta-Analysis (n=518,520)
Does baseline prehypertension increase the risk of incident stroke?
Prehypertension, particularly in the higher range (SBP 130-139 or DBP 85-89 mm Hg), is associated with a significantly increased risk of incident stroke.
Answers are grounded in this paper and cite their sources.
May inform stroke risk stratification in prehypertension; extends observational support but leaves intervention thresholds unresolved.
OBJECTIVE: To qualitatively and quantitatively assess the association of prehypertension with incident stroke through a meta-analysis of prospective cohort studies. METHODS: We searched Medline, Embase, the Cochrane Library, and bibliographies of retrieved articles. Prospective cohort studies were included if they reported multivariate-adjusted relative risks (RRs) and corresponding 95%confidence intervals (CI) of stroke with respect to baseline prehypertension. RESULTS: Twelve studies with 518,520 participants were included. Prehypertension was associated with risk of stroke (RR 1.55, 95% CI 1.35-1.79; p < 0.001). Seven studies further distinguished a low prehypertensive population (systolic blood pressure [SBP] 120-129 mm Hg or diastolic blood pressure [DBP] 80-84 mm Hg) and a high prehypertensive population (SBP 130-139 mm Hg or DBP 85-89 mm Hg). Among persons with lower-range prehypertension, stroke risk was not significantly increased (RR 1.22, 0.95-1.57). However, for persons with higher values within the prehypertensive range, stroke risk was substantially increased (RR 1.79, 95% CI 1.49-2.16). CONCLUSIONS: Prehypertension is associated with a higher risk of incident stroke. This risk is largely driven by higher values within the prehypertensive range and is especially relevant in nonelderly persons. Randomized trials to evaluate the efficacy of blood pressure reduction in persons with this designation are warranted.
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Lee et al. (2011) conducted a meta-analysis in Incident stroke (n=518,520). Baseline prehypertension vs. Normotension was evaluated on Incident stroke (RR 1.55, 95% CI 1.35-1.79, p=< 0.001). Baseline prehypertension was associated with a significantly increased risk of incident stroke (RR 1.55; 95% CI 1.35-1.79; p < 0.001), largely driven by higher values within the prehypertensive range.
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