Relation Between Blood Pressure and Stroke Mortality

• Published in: Hypertension (Dallas, Tex. 1979) Vol. 20; no. 5; pp. 601 - 605
• Main Authors: Palmer, Alison J, Bulpitt, Christopher J, Fletcher, Astrid E, Beevers, D Gareth, Coles, Edward C, Ledingham, John G.G, OʼRiordan, Paul W, Petrie, James C, Rajagopalan, Bheeshma E, Webster, John, Dollery, Colin T
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Heart Association, Inc 01.11.1992; Hagerstown, MD Lippincott
• Subjects: Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Cardiology. Vascular system; Cerebrovascular Disorders - etiology; Cerebrovascular Disorders - mortality; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Female; Humans; Hypertension - complications; Hypertension - physiopathology; Hypertension - therapy; Male; Medical sciences; Middle Aged; Risk Factors; Sex Factors; Human; Hypertension; Nervous system diseases; Stroke; Mortality; Cardiovascular disease; Statistical study; Cerebral disorder; Vascular disease; Treatment; Correlation analysis; Risk factor; Arterial pressure; Cerebrovascular disease
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/01.hyp.20.5.601

The relation between stroke mortality and blood pressure was investigated in 10,186 hypertensive patients followed up in the Department of Health Hypertension Care Computing Project for an average of 9 years. An untreated blood pressure measurement was available in 3,472 men and 3,405 women. The age-adjusted risk of stroke death increased by 1% for every 1 mm Hg increase in untreated systolic blood pressure. The relative hazard rate was 1.014 (95% confidence interval [CI], 1.007,1.021) in men and 1.009 (1.003,1.016) in women. The corresponding increases for 1 mm Hg for untreated diastolic blood pressure were almost 3% in men and again 1% in women (relative hazard rate 1.026 [95% CI, 1.014,1.038] in men and 1.010 [1.000, 1.021] in women). Treated blood pressure measurements were available in 3,073 men and 3,148 women. Stroke mortality increased by 2% for a 1 mm Hg increase in treated systolic pressure and 3% for the corresponding increase in diastolic blood pressure. The relation between stroke mortality and blood pressure was similar over and under the age of 65, although the increase in mortality with pressure was greater for treated diastolic blood pressure in women under the age of 65 than over this age. There was no evidence for a J-shaped relation between stroke mortality and either systolic or diastolic pressure in men. In women there was a suggestion of such a relation, but since this relation was also observed for untreated pressures, any increase in risk at lower pressures is unlikely to be a result of treatment.