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Updated: May 6, 2026
Real-Time Monitoring and Modulation of Blood Pressure in a Rabbit Model of Ischemic Stroke
Published on: February 10, 2023
Blood pressure control and primary prevention of stroke: summary of the recent clinical trial data and meta-analyses
Zbigniew Gaciong1, Maciej Siński, Jacek Lewandowski
1Department of Internal Medicine, Hypertension and Vascular Diseases, The Medical University of Warsaw, 1a Banacha Street, 02 097, Warsaw, Poland, zgaciong@hotmail.com.
Insights
High blood pressure significantly increases stroke risk. While antihypertensive therapy is proven effective, specific BP patterns like nocturnal hypertension and morning surge also predict risk, with current treatments lacking specific correction strategies.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Public Health
Background:
- Stroke is a leading cause of death and disability globally.
- Rising global burden of cerebrovascular diseases due to aging and lifestyle changes.
- High blood pressure (BP) is the primary modifiable risk factor for stroke, linked to 54% of cases.
Purpose of the Study:
- To review the impact of blood pressure on stroke risk.
- To discuss the role of BP variability and diurnal patterns in stroke prediction.
- To evaluate current treatment strategies for BP disturbances related to stroke.
Main Methods:
- Review of clinical trial evidence on antihypertensive therapy.
- Analysis of studies examining BP diurnal patterns and variability.
- Examination of primary prevention guidelines for the elderly.
Main Results:
- Antihypertensive therapy substantially reduces stroke risk, death, and disability.
- BP levels, diurnal patterns (nocturnal hypertension, morning surge), and variability are key stroke risk predictors.
- Effective modalities for correcting BP disturbances like chronotherapy are not yet established.
Conclusions:
- Managing high blood pressure is crucial for stroke prevention.
- Addressing specific BP patterns beyond absolute values may further reduce stroke risk.
- Further research is needed for effective interventions targeting BP variability and diurnal patterns.
Abstract:
Stroke is the second most common cause of death worldwide and of adult disability, but in the near future the global burden of cerebrovascular diseases will rise due to ageing and adverse lifestyle changes in populations worldwide. The risk of stroke increases at blood pressure levels above 115/75 mm Hg and high blood pressure (BP) is the most important modifiable risk factor for stroke, associated with 54 % episodes of stroke worldwide. There is strong evidence from clinical trials that antihypertensive therapy reduces substantially the risk of any type of stroke, as well as stroke-related death and disability. The risk attributed to BP is associated not only with absolute values but also with certain parameters describing BP diurnal pattern as well as short-term and long-term variability. Many studies reported that certain features of BP like nocturnal hypertension, morning surge or increased variability predict an increased stroke risk. However, there is no accepted effective modality for correction of these disturbances (chronotherapy, certain classes of antihypertensive drugs). In the elderly, who are mostly affected by stroke, the primary prevention guidelines recommend treatment with diuretics and calcium channel blockers to lower blood pressure to the standard level.
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