Optimal blood pressure for stroke prevention in healthy adults below 65 years: A nationwide 10-year observational study

Abstract

BackgroundThere have been few reports on the preventative value of intensive blood pressure (BP) management for stroke since the American College of Cardiology/American Heart Association (ACC/AHA) announced the new criteria for hypertension (HTN) in 2017. This study aimed to identify optimal BP for prevention of stroke in healthy adults under 65 years. MethodsWe conducted a 10-year observational study on the risk of stroke, subclassified as hemorrhagic stroke (HS) or ischemic stroke (IS), according to BP categories (low-normal BP, high-normal BP, elevated BP, stage 1 HTN, and stage 2 HTN) using the National Health Insurance Service Database. ResultsIn 2008, a health checkup was conducted for a total of 8,327,751 participants, and 949,551 of them enrolled in this study. The risk of HS increased from stage 2 HTN (adjusted hazard ratio [AHR], 3.036 [95 % confidence interval [CI], 2.159–4.252]) in men to stage 1 HTN (AHR, 2.972; 95 % CI, 2.256–3.897) in women. The risk of IS increased in both men (AHR, 1.404 [95 % CI, 1.164–1.693]) and women (AHR, 2.012 [95 % CI, 1.603–2.526]) with stage 1 HTN. The overall risk of stroke increased in men (AHR, 1.386; [95 % CI, 1.180–1.629]) and women (AHR, 2.363 [95 % CI, 1.973–2.830]) with stage 1 HTN. ConclusionThis study underscores the importance of maintaining BP below Stage 1 HTN to prevent stroke in healthy adults aged below 65 years. These findings highlight the significance of the new HTN guidelines established by the ACC/AHA in 2017.