Optimal blood pressure for stroke prevention in healthy adults below 65 years: A nationwide 10-year observational study

So Im Ryu, Sang Hyo Lee, Hyoung Soo Byoun, Young Deok Kim, Seung Pil Ban, Jae Seung Bang, O. K. Kwon, Chang Wan Oh, Si Un Lee

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1 Scopus citations

Abstract

Background: There have been few reports on the preventative value of intensive blood pressure (BP) management for stroke since the American College of Cardiology/American Heart Association (ACC/AHA) announced the new criteria for hypertension (HTN) in 2017. This study aimed to identify optimal BP for prevention of stroke in healthy adults under 65 years. Methods: We conducted a 10-year observational study on the risk of stroke, subclassified as hemorrhagic stroke (HS) or ischemic stroke (IS), according to BP categories (low-normal BP, high-normal BP, elevated BP, stage 1 HTN, and stage 2 HTN) using the National Health Insurance Service Database. Results: In 2008, a health checkup was conducted for a total of 8,327,751 participants, and 949,551 of them enrolled in this study. The risk of HS increased from stage 2 HTN (adjusted hazard ratio [AHR], 3.036 [95 % confidence interval [CI], 2.159–4.252]) in men to stage 1 HTN (AHR, 2.972; 95 % CI, 2.256–3.897) in women. The risk of IS increased in both men (AHR, 1.404 [95 % CI, 1.164–1.693]) and women (AHR, 2.012 [95 % CI, 1.603–2.526]) with stage 1 HTN. The overall risk of stroke increased in men (AHR, 1.386; [95 % CI, 1.180–1.629]) and women (AHR, 2.363 [95 % CI, 1.973–2.830]) with stage 1 HTN. Conclusion: This study underscores the importance of maintaining BP below Stage 1 HTN to prevent stroke in healthy adults aged below 65 years. These findings highlight the significance of the new HTN guidelines established by the ACC/AHA in 2017.

Original languageEnglish
Pages (from-to)44-52
Number of pages9
JournalJournal of Clinical Neuroscience
Volume122
DOIs
StatePublished - Apr 2024

Bibliographical note

Publisher Copyright:
© 2024 Elsevier Ltd

Keywords

  • Blood pressure
  • Hemorrhagic stroke
  • Hypertension
  • Ischemic stroke
  • Primary prevention
  • Risk factors
  • Stroke

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