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Stroke morbidity in patients treated for hypertension--The Skaraborg Hypertension Project
U Lindblad1, L Råstam, J Ranstam
1Department of Community Health Sciences, University of Lund, Malmö, Sweden.
Insights
Hypertension increases stroke risk in men and women, but treated hypertension shows a better prognosis than previously thought. This finding is crucial for developing future hypertension treatment guidelines.
Area of Science:
- Cardiovascular Medicine
- Epidemiology
- Public Health
Background:
- Hypertension is a significant risk factor for stroke.
- Previous studies suggested a poor prognosis for stroke in hypertensive patients.
- Understanding the impact of treated hypertension on stroke risk is essential for clinical practice.
Purpose of the Study:
- To analyze stroke incidence in a cohort of hypertensive patients compared to population controls and normotensive subjects.
- To evaluate the prognosis of treated hypertension concerning stroke morbidity and mortality.
- To inform the development of updated hypertension treatment guidelines.
Main Methods:
- Analysis of a Swedish cohort of 1428 men and 1812 women with hypertension.
- Comparison with age- and sex-matched population controls (1:1) and normotensive untreated subjects.
- Mean follow-up of 8.3 years for patients aged 40-69 at baseline (1977-1981).
Main Results:
- Hypertensive men and women showed increased relative risks for stroke morbidity (1.63 and 1.40, respectively) and mortality (1.96 and 1.48, respectively) compared to population controls.
- Compared to normotensive subjects, adjusted relative risks for stroke morbidity were significantly higher for hypertensive men (3.07) and women (2.56).
- The prognosis for stroke in treated hypertensive patients appears more favorable than anticipated.
Conclusions:
- Treated hypertension is associated with a better stroke prognosis than previously indicated by research.
- These findings necessitate a re-evaluation of current hypertension management strategies.
- Consideration of these results is vital for refining future clinical guidelines for hypertension treatment.
Abstract:
Stroke incidence was analysed in a Swedish cohort of male (n = 1428) and female (n = 1812) hypertensive patients in comparison with age- and sex-matched population controls (1:1) and with normotensive untreated subjects (1249 men and 1247 women). Mean follow-up was 8.3 years. Patients were aged 40-69 at the start of follow-up in 1977-1981. Relative risks (95% confidence interval [CI]) for stroke morbidity were 1.63 (1.16, 2.29) for men and 1.40 (0.94, 2.09) for women compared to population controls. Corresponding figures for stroke mortality were 1.96 (1.01-3.82) and 1.48 (0.71-3.06). Compared to the normotensive sample with adjustment for smoking and body mass index relative risks for stroke morbidity were 3.07 (1.96-4.80) for men and 2.56 (1.46-4.51) for women. The prognosis of treated hypertension with respect to stroke is better than anticipated from previous studies, a fact that should be considered when treatment guidelines are developed.