High Blood Pressure is a Clue




Knowing the path of a person’s blood pressure from middle age onward may help doctors better assess the health risks posed by high blood pressure and could lead to earlier interventions to prevent stroke and other diseases linked to high blood pressure, according to research in the American Heart Association’s journal Hypertension.

“[M]ost studies looking at the relationship between high blood pressure and stroke have relied on a blood pressure measurement at a single point in time, rather than looking at the course of blood pressure and stroke risk,” said M. Arfan Ikram, M.D., Ph.D., senior study author and associate professor of neuroepidemiology at Erasmus University Medical Center in Rotterdam, the Netherlands.

Dutch researchers tracked the systolic (top number) blood pressure of 6,745 participants, age 55-106, living in a suburb of Rotterdam for over two decades.

Researchers identified four distinct blood pressure trajectories in people 55 and older:

  • Class 1 experienced gradually increasing blood pressure from normal systolic blood pressure (120 mm Hg) in middle age to high systolic blood pressure (160 mm Hg) at age 95. Class 1 was the most common trajectory.
  • Class 2 began with normal blood pressures in middle age but experienced a steep increase to very high systolic blood pressure (200 mm Hg) over the same time period.
  • Class 3 had moderate high systolic blood pressure (140 mm Hg) in middle age that did not change much over time.
  • Class 4 had high systolic blood pressure (160 mm Hg) in middle age, but their blood pressure decreased after age 65. Class 4 were more frequently men and more often used medication.

The study accounted for blood pressure lowering medications, smoking, alcohol use, body weight and other factors that might bias results. After adjustment, researchers found:

  • Those whose blood pressure climbed steeply with time (Class 2) and those with high blood pressure that decreased after age 65 (Class 4) had the highest risk of stroke and dying from non-stroke diseases up to the age of 80.
  • People with moderately high blood pressure at mid-life and throughout (Class 3), had the highest risk of stroke overall but their risk of dying from non-stroke events, along with those in Class 1, was the lowest.
  • Those with normal baseline and gradually increasing blood pressure from borderline-high to high (Class 1) had the lowest risk of stroke and a low risk of death for non-stroke events.

During the study period, 1,053 participants experienced a stroke. Researchers also studied the number of deaths that occurred from non-stroke health events. High blood pressure also increases the chances of dying from heart attack, heart failure, kidney disease and other diseases.

“Blood pressure should be measured regularly because it can change markedly over the course of a couple years, and put you at high risk for an adverse event,” said Ikram. “Since the risk of stroke and death differ across these trajectory paths, they are potentially important for preventive strategies.”

Source: American Heart Association News

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