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Blood pressure measures and risk of total, ischemic, and hemorrhagic stroke in men

T S Bowman1, J M Gaziano, C S Kase

  • 1Veterans Affairs Boston Healthcare System - Massachusetts Veterans Affairs Epidemiology, Research and Information Center, Boston, MA 02130, USA. tsbowman@partners.org

Neurology
|September 13, 2006
PubMed

Insights

Systolic blood pressure (SBP) is the best predictor of stroke risk. This study found SBP alone sufficiently predicts total, ischemic, and hemorrhagic stroke risk in men.

Area of Science:

  • Cardiovascular epidemiology
  • Neurology
  • Public health

Background:

  • Stroke remains a leading cause of disability and death worldwide.
  • Accurate prediction of stroke risk is crucial for effective prevention strategies.
  • Various blood pressure measures are used, but their relative predictive power for different stroke types is debated.

Purpose of the Study:

  • To determine which blood pressure measurement best predicts the risk of total, ischemic, and hemorrhagic stroke.
  • To compare the predictive utility of systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure, and mean arterial pressure for stroke risk.

Main Methods:

  • Prospective cohort study of 11,466 men from the Physicians' Health Study with a median follow-up of 19.4 years.
  • Self-reported systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded.
  • Cox proportional hazards models were used to calculate relative risks (RRs) and 95% confidence intervals (CIs) for stroke subtypes.

Main Results:

  • An increase of 10 mm Hg in SBP was associated with significantly higher risks for total, ischemic, and hemorrhagic stroke.
  • While DBP, pulse pressure, and mean arterial pressure were significant predictors, SBP alone was not outperformed by any other measure.
  • Adding DBP to SBP did not significantly improve the prediction model for any stroke type.

Conclusions:

  • Systolic blood pressure is a consistent and significant predictor of total, ischemic, and hemorrhagic stroke in initially healthy men.
  • SBP alone is sufficient for predicting the risk of total stroke and its major subtypes.
  • These findings support the primary use of SBP in stroke risk assessment and management.
Abstract

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