Reduction in systolic BP below 140, important in primary stroke prevention

Washington: A new research has revealed that people 60 or older, especially minorities and women, have a lower risk of stroke if the top number (systolic) in their blood pressure is below 140 millimeters of mercury (mm Hg).

The new study, by researchers at Miami and Columbia University, support what some health experts had feared, lead author Chuanhui Dong said that raising the treatment bar could lead to more strokes.

Dong added that the elevated stroke rate for people in the 140-149 range is close to the 80 percent higher risk the study found for people with systolic readings at or above 150, suggesting that blood pressure from 140-149 is just as strong of a stroke risk factor as levels of 150 and greater.

Hispanics with systolic readings of 140-149 had 2.4 times the risk of a first stroke.

Blacks with systolic readings of 140-149 had twice the risk. No such difference was seen in non-Hispanic whites, but their numbers in the study were too small for firm conclusions to be drawn, researchers said.

Healthcare providers should heed these findings, Dong said, because Hispanics and blacks are known to suffer strokes more frequently than whites and raising the threshold for hypertension treatment could have a worse effect on racial-ethnic disparities in stroke risk reduction.

Women in the study with a systolic pressure of 140-149 faced nearly double the risk of a first stroke, compared with those below the 140 threshold, while men in the 140-149 range had a 34 percent higher risk.

Dong concluded that hypertension is the most established and modifiable risk factor for stroke, one of the leading causes of death and disability and reduction in systolic blood pressure below 140 is important in primary stroke prevention, even among those over 60 without diabetes or chronic kidney disease.