High blood pressure has long been considered the most important risk factor for stroke, but the latest research – published in the online issue of the journal Neurology – indicates that even slightly elevated blood pressure may be dangerous.
An analysis of 12 studies of 518 adults in total found that those with blood pressure slightly above normal – a condition known as prehypertensive – were 520 percent more likely to have a stroke than those with normal blood pressure. In the United States, one in three adults is prehypertensive. According to the authors of the study, if future research confirms this finding, it may turn out that slightly elevated blood pressure requires more aggressive therapy than just lifestyle changes. Current methods of lowering blood pressure in people with prehypertension include losing weight, exercising regularly, reducing salt intake and quitting smoking. In addition, physicians may prescribe medications for patients with pre-hypertension and underlying medical conditions such as pre-diabetes or diabetes.
Prehypertension is defined as when the systolic blood pressure (i.e. the higher blood pressure measured while the heart is pumping blood) is between 120 and 139 mmHg (mercury), or the diastolic blood pressure (lower values, measured when the heart is at rest) is from 80 to 89 mm Hg.
According to physician Seemant Chaturvedi, who is not a co-author of the study, the results contribute to the discussion of when to start taking medications to lower blood pressure. We talk about normal blood pressure when the systolic blood pressure is below 120 mm Hg, and the diastolic pressure below 80 mm Hg. Usually, blood pressure-lowering drugs are not started until there is high blood pressure – when the blood pressure is 140/90 mm Hg or higher. But the norm for blood pressure may drop. This kind of modification of the norm happened with the total cholesterol level: 240, once considered the ideal level, gradually decreased to 200.
“Blood pressure norms can be a lot like cholesterol,” said Chaturvedi, who heads the stroke program at Wayne State University and is a member of the American Academy of Neurology. – Everyone knows that the standards for cholesterol have been lowered.
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Prehypertension was defined in 2003 in the National Hypertension Education Program run by the US National Heart, Lung, and Blood Institute. Experts recognized it as a precursor to hypertension – but not a risk factor for stroke – and called for more research into the condition. All 12 studies that were the subject of the most recent analysis were completed after 2003.
It also showed that:
– People under 65 years of age with prehypertension were nearly 68 percent. more likely to suffer a stroke than those who had normal blood pressure.
– The risk of stroke for people with systolic blood pressure in the range 130-139 mm Hg was 79%. higher than those with pressure considered to be the closest to the norm.
“Prehypertension is a very controversial phenomenon,” explains lead author Bruce Ovbiagele, director of the stroke prevention program at the University of California, San Diego. “When it was first defined, people accused experts of creating an artificial group of patients just to take drugs.
Karen Furie, a doctor who is not a co-author of this recent study, explains that the 55 percent risk of stroke is a moderate risk, and that prehypertension is “very likely” a risk factor for stroke as it often leads to high blood pressure. “The significance of this latest work is that it is a synthesis of the results of research conducted on a group of about half a million people,” said Furie, a member of the American Academy of Neurology. – The conclusions drawn from it, however, require confirmation in further studies – he sums up.
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Text: Janice Lloyd