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Research Paper|Volume 11, Issue 16|pp 6522—6534

Strict target blood pressure management for reducing the stroke risk according to 2017 ACC/AHA blood pressure guideline

Peng Zhao1, Jie Liu1,2,3, Conglin Wang4, Wei Zhao5, Yanqiu Zhang6, Hongfei Gu7, Jun Tu1,2,3, Jinghua Wang1,2,3, Xianjia Ning1,2,3
  • 1Department of Neurology, Tianjin Medical University General Hospital, Tianjin 300052, China
  • 2Department of Epidemiology, Tianjin Neurological Institute, Tianjin 300052, China
  • 3Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin 300052, China
  • 4Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China
  • 5Department of Neurology, Tianjin TEDA Hospital, Tianjin 300457, China
  • 6Department of Neurology, Tianjin Nankai Hospital, Tianjin 300100, China
  • 7Department of Neurosurgery, Tianjin Haibin People’s Hospital, Tianjin 300280, China
* Equal contribution
Received: May 27, 2019Accepted: August 12, 2019Published: August 27, 2019
https://doi.org/10.18632/aging.102207

Copyright © 2019 Zhao et al. This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 3.0) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

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.