J-shaped relation between blood pressure and stroke in treated hypertensives

Zoltán Vokó, Michiel L. Bots, Albert Hofman, Peter J. Koudstaal, Jacqueline C.M. Witteman, Monique M.B. Breteler

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145 Citations (Scopus)

Abstract

The objective of this study was to investigate the relationship between hypertension and risk of stroke in the elderly. The study was performed within the framework of the Rotterdam Study, a prospective population-based cohort study. The risk of first-ever stroke was associated with hypertension (relative risk, 1.6; 95% CI, 1.2 to 2.0) and with isolated systolic hypertension (relative risk, 1.7; 95% CI, 1.1 to 2.6). We found a continuous increase in stroke incidence with increasing blood pressure in nontreated subjects. In treated subjects, we found a J-shaped relation between blood pressure and the risk of stroke. In the lowest category of diastolic blood pressure, the increase of stroke risk was statistically significant compared with the reference category. Hypertension and isolated systolic hypertension are strong risk factors for stroke in the elderly. The increased stroke risk in the lowest stratum of blood pressure in treated hypertensive patients may indicate that the therapeutic goal of 'the lower the better' is not the optimal strategy in the elderly.

Original languageEnglish
Pages (from-to)1181-1185
Number of pages5
JournalHypertension
Volume34
Issue number6
DOIs
Publication statusPublished - Dec 1999

Keywords

  • Blood pressure
  • Cerebrovascular disorders
  • Cohort studies
  • Drug therapy
  • Stroke

ASJC Scopus subject areas

  • Internal Medicine

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    Vokó, Z., Bots, M. L., Hofman, A., Koudstaal, P. J., Witteman, J. C. M., & Breteler, M. M. B. (1999). J-shaped relation between blood pressure and stroke in treated hypertensives. Hypertension, 34(6), 1181-1185. https://doi.org/10.1161/01.HYP.34.6.1181