Blood pressure cause stroke
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Blood Pressure and Stroke: Understanding the Connection
Hypertension as a Leading Risk Factor for Stroke
Hypertension, or high blood pressure, is the most significant modifiable risk factor for stroke, which is the second leading cause of death and a major cause of disability worldwide . Elevated blood pressure damages the arteries, making them more susceptible to plaque buildup, which can lead to blockages and subsequent strokes. The risk of stroke increases significantly at blood pressure levels above 115/75 mm Hg, with high blood pressure being associated with 54% of stroke episodes globally.
Blood Pressure Management for Stroke Prevention
Effective management of blood pressure is crucial for both the primary and secondary prevention of stroke. Clinical trials have shown that antihypertensive therapy can substantially reduce the risk of stroke, stroke-related death, and disability . A reduction in systolic blood pressure by 10-12 mm Hg and diastolic blood pressure by 5-6 mm Hg can lead to a 38% reduction in stroke incidence. Current guidelines recommend maintaining a systolic blood pressure under 140 mm Hg for stroke prevention, though more intensive targets may benefit certain patients.
Blood Pressure Variability and Stroke Risk
Not only the absolute values of blood pressure but also its variability plays a role in stroke risk. Features such as nocturnal hypertension, morning surge, and increased variability are predictors of higher stroke risk. However, there is no universally accepted method for correcting these disturbances, and more research is needed to determine effective strategies.
Acute Stroke and Blood Pressure
High blood pressure is common in acute stroke and is associated with poor outcomes, including death, dependency, and deterioration . A systematic review found that elevated mean arterial blood pressure (MABP) and diastolic blood pressure (DBP) are significantly associated with increased mortality in acute stroke patients. Moderate lowering of blood pressure in the acute phase of stroke might improve outcomes, but this needs to be tested in large, randomized trials.
Sex and Ethnic/Racial Differences in Blood Pressure and Stroke
There are notable differences in how blood pressure affects stroke risk across different sexes and ethnic/racial groups. Males tend to have higher blood pressure in early adulthood, while females overtake males in middle age. Additionally, high blood pressure has a more significant impact on stroke burden among Black and Asian individuals compared to Whites, likely due to differences in lifestyle, socioeconomic status, and healthcare resources. This highlights the need for tailored prevention and treatment strategies to address these disparities.
Conclusion
Hypertension is a critical and modifiable risk factor for stroke. Effective blood pressure management can significantly reduce the risk of both first-time and recurrent strokes. While current guidelines provide a framework for blood pressure targets, ongoing research is essential to refine these recommendations and address the variability in stroke risk across different populations. Understanding and managing blood pressure effectively is key to reducing the global burden of stroke.
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