Abstract
Objectives: Hypertension was the most important risk factor for ischemic stroke. In China, three fourths of treated hypertensive didn’t meet the standard of control. We analyzed the relationship between systolic blood pressure, diastolic blood pressure, pulse pressure and mean arterial pressure and Ischemic stroke in patients with uncontrolled hypertension. Methods: In this cross-sectional survey, subjects with uncontrolled hypertension aged above 35 years were recruited from the general medicine clinic of Beijing Anzhen Hospital and its affiliated community health centers from March to December 2012. Results: After adjusted for 7 covariates, each index was significantly correlated with ischemic stroke according to the result of single index model. SBP ≥ 150 mmHg, DBP ≥ 100 mmHg, high textile and quartile PP and high quartile MAP were associated with higher risk of ischemic stroke. When SBP and DBP or SBP and MAP were introduced into the model together, no significant difference was noted across categories of DBP and MAP, DBP and PP were introduced into the model together, no significant difference was noted across categories of DBP. Four indexes were introduced to the multifactorial model, only SBP entered into the model. Compared with SBP <140 mmHg, relative risk of stroke was 2.777 (95% CI: 1.356∼5.688) for SBP between 150-159 mmHg, 2.116 (95% CI: 1.0384.314) for SBP ≥ 160 mmHg. SBP showed the biggest area under ROC curves, which is 64.3%. Conclusions: SBP is associated with higher risk of ischemic stroke in patients with uncontrolled hypertension than other three blood pressure indexes. The risk of ischemic stroke would decrease when SBP was less than 150 mmHg.
Highlights
Stroke is the leading cause of death in China nowadays
When Systolic blood pressure (SBP) and diastolic blood pressure (DBP) or SBP and mean arterial pressure (MAP) were introduced into the model together, no significant difference in stroke risk was noted across categories of DBP and MAP
DBP and Pulse pressure (PP) were introduced into the model together; no significant difference in stroke risk was noted across categories of DBP
Summary
Stroke is the leading cause of death in China nowadays. In recent years, changes have occurred in the incidence and subtype of stroke. A follow-up study of the incidence of stroke from 1982 to 2000 in 10 communities across China suggested that the incidence of ischemic stroke was significantly higher than that of hemorrhagic stroke [1]. The prevalence of adult hypertension was 18.8% in China, and the estimated number of patients with hypertension was 266 million, 24.7% of them were treated, and the control rate was 25% for the treated patients [4]. It meant that most patients didn’t meet the standard of control; they were likely to be higher risk of stroke
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