Key result
Stage 2 hypertension, as defined by the 2017 ACC/AHA guidelines, significantly increased the risk of first-ever stroke compared to normal blood pressure (HR 3.48) in a rural Chinese population.
Why the study?
The authors explored new blood pressure thresholds and their impact on first-ever stroke risk determinations.
Do elevated blood pressure and hypertension stages defined by the 2017 ACC/AHA guidelines increase the risk of first-ever stroke?
Cohort (n=3,906)
Do elevated blood pressure and hypertension stages defined by the 2017 ACC/AHA guidelines increase the risk of first-ever stroke?
Hazard Ratio: 3.48 (95% CI 2.61–4.64)
Absolute Event Rate: 15.53% vs 2.87%
p-value: p=<0.001
Elevated blood pressure categories according to the 2017 ACC/AHA guidelines are significantly associated with an increased risk of first-ever stroke, supporting strict blood pressure targets (<120/80 mmHg) particularly in young and middle-aged men.
Associated with higher stroke risk in rural Chinese adults; extends 2017 guideline associations but leaves causal targets open pending trials.
BACKGROUND AND PURPOSE: We explored the new BP thresholds and their impact on first-ever stroke risk determinations. RESULTS: During a mean following-up period of 21.85 years, 638 first-ever strokes occurred among 3906 participants. After adjusting for covariates, the hazard ratios for ischemic stroke (IS) in men aged <60 years were significant higher in participants with elevated BP, stage 1 hypertension, and stage 2 hypertension than normal BP (all P<0.05); an increased risk of intracerebral hemorrhage (ICH) was also observed for those with stage 2 hypertension. Similarly, in women aged, the risk of stroke increased for those with stage 2 hypertension both in <60 years and in ≥60 years. Moreover, more than 60% of incident strokes were attributed to systolic BP (SBP) ≥120mmHg and diastolic BP (DBP) <80mmHg in men aged <60 years. CONCLUSIONS: Elevated BP increases the risk of developing stroke, particularly in the absence of routine BP measurements and hypertension treatment. A strict BP management target (SBP, <120 mmHg; DBP, <80 mmHg) should be adopted for young and middle-aged men. METHODS: This population-based cohort study was conducted between October 1991 and January 2018. The association of BP categories, defined by the 2017 ACC/AHA BP guideline, with first-ever stroke risk was assessed using Cox regression models.
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Zhao et al. (2019) conducted a cohort in First-ever stroke (n=3,906). Stage 2 hypertension (2017 ACC/AHA guidelines) vs. Normal blood pressure was evaluated on Incidence of first-ever stroke (HR 3.48, 95% CI 2.61-4.64, p=<0.001). Stage 2 hypertension, as defined by the 2017 ACC/AHA guidelines, significantly increased the risk of first-ever stroke compared to normal blood pressure (HR 3.48) in a rural Chinese population.
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