Advanced

Blood Pressure Control and Risk of Stroke. A Population-Based Prospective Cohort Study.

Li, Cairu LU ; Engström, Gunnar LU ; Hedblad, Bo LU ; Berglund, Göran LU and Janzon, Lars LU (2005) In Stroke: a journal of cerebral circulation 36(4). p.725-730
Abstract
Background and Purpose— Adequate control of blood pressure (BP) is a cornerstone in stroke prevention. This study explored the risk of stroke in relation to the quality of BP control in a population-based cohort and whether control of hypertension was related to background characteristics of patients.



Methods— A total of 27 936 subjects (10 953 men and 16 983 women), 45 to 73 years old, living in Malmö, Sweden participated in the study. Incidence of stroke was followed-up for a mean period of 6 years. Controlled BP was defined as BP <140/90 mm Hg in subjects with pharmacological treatment for hypertension.



Results— In the whole cohort, 16 648 subjects (60%) had hypertension (BP ≥140/90 mm Hg) and... (More)
Background and Purpose— Adequate control of blood pressure (BP) is a cornerstone in stroke prevention. This study explored the risk of stroke in relation to the quality of BP control in a population-based cohort and whether control of hypertension was related to background characteristics of patients.



Methods— A total of 27 936 subjects (10 953 men and 16 983 women), 45 to 73 years old, living in Malmö, Sweden participated in the study. Incidence of stroke was followed-up for a mean period of 6 years. Controlled BP was defined as BP <140/90 mm Hg in subjects with pharmacological treatment for hypertension.



Results— In the whole cohort, 16 648 subjects (60%) had hypertension (BP ≥140/90 mm Hg) and 23% of them received treatment. Among treated hypertensives, 88.2% had BP levels ≥140/90 mm Hg and 49.5% had BP levels ≥160/100 mm Hg. During the follow-up, 137 strokes occurred among treated hypertensive subjects. The crude incidence of stroke was 289/100 000 person-year in controlled hypertensive subjects and 705/100 000 person-year in treated hypertensive subjects with BP ≥140/90 mm Hg. It was estimated that {approx}45% of all strokes among subjects with treatment for hypertension might be attributed to uncontrolled BP. In treated hypertensives, the risk of stroke increased significantly with advancing age, current smoking, high level of diastolic BP, and diabetes. In hypertensive subjects without treatment (n=12 819), incidence of stroke was 363/100 000 person-year.



Conclusion— Uncontrolled BP is highly prevalent in patients with pharmacological treatment for hypertension. More than 90% of stroke in this group occurred in those with uncontrolled BP. Adequate hypertension control may prevent a substantial proportion of first-ever stroke among treated hypertensives. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
blood pressure, hypertension, stroke
in
Stroke: a journal of cerebral circulation
volume
36
issue
4
pages
725 - 730
publisher
American Heart Association
external identifiers
  • wos:000228039700011
  • pmid:15746450
  • scopus:16844384024
ISSN
1524-4628
DOI
10.1161/01.STR.0000158925.12740.87
language
English
LU publication?
yes
id
e32bc12f-14b4-4a69-aa8a-941d4288fed0 (old id 135193)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15746450&dopt=Abstract
date added to LUP
2007-07-25 11:30:49
date last changed
2017-10-01 04:45:53
@article{e32bc12f-14b4-4a69-aa8a-941d4288fed0,
  abstract     = {Background and Purpose— Adequate control of blood pressure (BP) is a cornerstone in stroke prevention. This study explored the risk of stroke in relation to the quality of BP control in a population-based cohort and whether control of hypertension was related to background characteristics of patients.<br/><br>
<br/><br>
Methods— A total of 27 936 subjects (10 953 men and 16 983 women), 45 to 73 years old, living in Malmö, Sweden participated in the study. Incidence of stroke was followed-up for a mean period of 6 years. Controlled BP was defined as BP &lt;140/90 mm Hg in subjects with pharmacological treatment for hypertension.<br/><br>
<br/><br>
Results— In the whole cohort, 16 648 subjects (60%) had hypertension (BP ≥140/90 mm Hg) and 23% of them received treatment. Among treated hypertensives, 88.2% had BP levels ≥140/90 mm Hg and 49.5% had BP levels ≥160/100 mm Hg. During the follow-up, 137 strokes occurred among treated hypertensive subjects. The crude incidence of stroke was 289/100 000 person-year in controlled hypertensive subjects and 705/100 000 person-year in treated hypertensive subjects with BP ≥140/90 mm Hg. It was estimated that {approx}45% of all strokes among subjects with treatment for hypertension might be attributed to uncontrolled BP. In treated hypertensives, the risk of stroke increased significantly with advancing age, current smoking, high level of diastolic BP, and diabetes. In hypertensive subjects without treatment (n=12 819), incidence of stroke was 363/100 000 person-year.<br/><br>
<br/><br>
Conclusion— Uncontrolled BP is highly prevalent in patients with pharmacological treatment for hypertension. More than 90% of stroke in this group occurred in those with uncontrolled BP. Adequate hypertension control may prevent a substantial proportion of first-ever stroke among treated hypertensives.},
  author       = {Li, Cairu and Engström, Gunnar and Hedblad, Bo and Berglund, Göran and Janzon, Lars},
  issn         = {1524-4628},
  keyword      = {blood pressure,hypertension,stroke},
  language     = {eng},
  number       = {4},
  pages        = {725--730},
  publisher    = {American Heart Association},
  series       = { Stroke: a journal of cerebral circulation},
  title        = {Blood Pressure Control and Risk of Stroke. A Population-Based Prospective Cohort Study.},
  url          = {http://dx.doi.org/10.1161/01.STR.0000158925.12740.87},
  volume       = {36},
  year         = {2005},
}