Prehypertension Associated With Stroke Risk

Prehypertenstion, blood pressure measuring below the hypertension threshold but above normal BP levels, is associated with an increased risk of stroke, according to a new study.

In an analysis of data pooled from 19 studies including 762,393 participants, researchers from the Southern Medical University in Guangzhou, China, measured the relationship between prehypertension and stroke risk.

Note: The threshold for high blood pressure diagnosis, or hypertension, is 140/90 mm Hg.
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Participants were followed for 4 to 36 years. The data showed that 25.2% to 54.2% had prehypertension.

Researchers adjusted for BP levels, stroke type, age, sex, and ethnicity, and controlled for other cardiovascular risk factors. They found that individuals with prehypertension were 66% more likely to have a stroke than those with normal BP.

Furthermore, researchers noted that the risk of stroke was higher (95%) among individuals with high-range prehypertension (130-139 systolic BP) compared with individuals with low-range prehypertension (44%).

"Considering the high incidence of pre-hypertension, up to 30% to 50%, successful intervention in this large population could have a major public health impact," researchers wrote, recommending that lifestyle interventions be "the mainstay treatment.”

Limitations of the study included a lack of patient-level data and the use of single-day measurement of BP to define prehypertension.

The study was published in Neurology.

–Michael Potts

Huang Y, Cai X, Li Y, Su L, et al. Prehypertension and the risk of stroke [published online ahead of print March 12, 2014] Neurology. doi: 10.1212/WNL.0000000000000268