WHAT IS THE STRONGEST PREDICTOR AMONG BP RELATED FACTORS FOR STROKE?: PP.4.152

Abstract

Objectives: Hypertension is the strongest risk factor for stroke. We used systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean blood pressure (MBP) as a predictor of stroke event. The purpose of this paper is to clear what is the best assessment among these factors concerned with blood pressure (BP) for predictor of stroke event by subtypes. Design and Method: Risk of stroke and subtypes using 156, 892 mass screening examination cases from 1991 to 1998 and 1,323 stroke events within 2 years after the examination were analyzed by multiple logistic regression (MLR). Age, sex, diabetes mellitus, serum cholesterol, body mass index, smoking, drinking were used fixed predictor, and choice one of BP related factor (SBP or DBP or PP or MBP) included predictors, and estimate relative risk of BP related factors and Nagelkerke R-squared of MLR models that was used the measurement of fitness for MLR formula. Results: The BP related factors for the risk of stroke events showed stronger than other predictors. The risk proportion of SBP increasing per 1 mmHg by cerebral hemorrhage, subarachnoid hemorrhage and cerebral infarction is 3.9%, 2.9% and 1.8%, that of DBP is 2.7%, 1.2% and 1.1%, that of PP is 2.2%, 2.1% and 1.8%, that of MBP is 3.5%, 2.2% and 1.9%, respectively. Cerebral hemorrhage showed the best sensibility compare with other subtypes by BP related factors. Nagelkerke R-squared of MLR in total stroke by SBP, DBP, PP and MBP was 0.108, 0.099, 0.096 and 0.107, respectively. That in cerebral hemorrhage was 0.103, 0.079, 0.077 and 0.094, and in cerebral infarction was 0.124, 0.117, 0.119 and 0.121, in subarachnoid hemorrhage was 0.055, 0.041, 0.039 and 0.048, respectively. SBP showed the highest score in every stroke subtypes. Conclusion: All BP related factors showed the strongest controllable risk factors of stroke subtypes. SBP was the best factor for predicted stroke event, especially.