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Even Low-Range Prehypertension BP Seems Associated with Increased Stroke Risk — Physician’s First Watch

Medical News |
March 13, 2014

Even Low-Range Prehypertension BP Seems Associated with Increased Stroke Risk

By Kelly Young

Prehypertension is associated with increased stroke risk, even after controlling for other cardiovascular risk factors, according to a new meta-analysis in Neurology.

In 19 prospective cohort studies including more than 750,000 people, 25% to 54% of participants had prehypertension — a blood pressure reading of 120-139/80–89 mm Hg. After multivariable adjustment, prehypertension was associated with increased risk for stroke, compared with optimal BP (relative risk, 1.66). BP levels at the higher range of prehypertension (130-139 systolic BP) were associated with greater risk than levels at the lower end, but even systolic BPs in the 120s carried increased stroke risk.

The authors recommend lifestyle intervention for patients with prehypertension. They say that future randomized trials should assess drug treatments in high-risk patients, such as those with high-range prehypertension along with other risk factors.

Reader Comments (4)

Carol Vassar, MD Physician, Internal Medicine, private practice

The Journal Watch comment is much more helpful than this summary. The reminder that increased risk does not mean that treatment will decrease the risk is very important. The category of BP /80-85 does not strike me as particularly low risk. The people with BP120's/- did they also have diastolics 80-85? Also important, what is overall mortality as BP's go down further?

Sheldon Ball MD, PhD Physician, Geriatrics, Anvita Health

per a prior Journal Watch editorial: Be careful not to extend the findings of a study to persons outside of the study group... It appears that the study subjects were largely Han Chinese.

Z Acheson MD

How does this intersect with emerging data and the JNC 8 recommendations stating that SBP's of 150 are adequate in some age groups?

tom reed retired

thanks .......helpful piece.....recently had 1 -2 TIAs at age 83.........bp 3/13am was 137/78

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