{"id":10942,"date":"2016-02-06T08:00:04","date_gmt":"2016-02-06T14:00:04","guid":{"rendered":"http:\/\/www.paristn.net\/articles\/?p=10942"},"modified":"2016-02-05T23:53:47","modified_gmt":"2016-02-06T05:53:47","slug":"older-healthy-adults-with-systolic-bp-below-140-have-lower-stroke-risk","status":"publish","type":"post","link":"https:\/\/www.paristn.net\/articles\/2016\/02\/06\/older-healthy-adults-with-systolic-bp-below-140-have-lower-stroke-risk\/","title":{"rendered":"Older, Healthy Adults with systolic BP below 140 have Lower Stroke Risk"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-56563\" title=\"American Heart Association\" src=\"http:\/\/www.clarksvilleonline.com\/wp-content\/uploads\/2010\/12\/American-Heart-Association-new-logo-480x230.jpg\" alt=\"American Heart Association\" width=\"240\" height=\"115\" \/><strong>Dallas, TX<\/strong> &#8211; Raising the <a href=\"http:\/\/www.heart.org\/HEARTORG\/Conditions\/HighBloodPressure\/AboutHighBloodPressure\/Understanding-Blood-Pressure-Readings_UCM_301764_Article.jsp#.VpWYyPLlvIU\" title=\"systolic blood pressure\"  target=\"_blank\">systolic blood pressure<\/a> threshold from 140 to 150 mmHg, as a new target for high blood pressure treatment in older people who don\u2019t have chronic kidney disease or diabetes, could put this population at greater stroke risk, according to new research in the American Heart Association\u2019s journal <em>Hypertension<\/em>.<\/p>\n<p>The increased stroke risk is even more pronounced among Hispanics and blacks, the research showed.<\/p>\n<div id=\"attachment_277182\" style=\"width: 490px\" class=\"wp-caption aligncenter\"><a target=\"_blank\" href=\"http:\/\/www.clarksvilleonline.com\/wp-content\/uploads\/2014\/09\/Blood-pressure-cuff.jpg\"  rel=\"attachment wp-att-277182\" class=\"thickbox no_icon\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-277182\" class=\"size-medium wp-image-277182\" title=\"Blood pressure cuff. (American Heart Association)\" src=\"http:\/\/www.clarksvilleonline.com\/wp-content\/uploads\/2014\/09\/Blood-pressure-cuff-480x360.jpg\" alt=\"Blood pressure cuff. (American Heart Association)\" width=\"480\" height=\"360\" \/><\/a><p id=\"caption-attachment-277182\" class=\"wp-caption-text\">Blood pressure cuff. (American Heart Association)<\/p><\/div>\n<p><!--more-->In 2014, panel members appointed to the Eighth Joint National Committee, known as the JNC 8, published a paper in the <em>Journal of the American Medical Association<\/em> recommending treatment of high blood pressure in people 60 years and older whose systolic pressure \u2013 the top number in a blood pressure reading \u2013 was 150.<\/p>\n<p>The paper, however, was not an official guideline.<\/p>\n<p>\u201cWe started this analysis very soon after [the <em>JAMA<\/em> paper] came out \u2026 because we were concerned about the recommendation\u2019s potential effect on stroke prevention,\u201d said study author Ralph L. Sacco, M.D., professor and chair of neurology at the University of Miami Miller School of Medicine.<\/p>\n<p>Sacco and colleagues from University of Miami and Columbia University studied 1,750 people ages 60 years and older, who were free of stroke, diabetes and chronic kidney disease.<\/p>\n<p>Researchers measured participants\u2019 systolic blood pressure at the study\u2019s start and noted during an average 13 years if any of those patients had strokes. Among those studied, 63 percent were women, 48 percent were Hispanic, 25 percent white, and 25 percent black. Forty-three percent of participants had systolic readings of less than 140 mmHg; 20 percent were between 140 and 149 mmHg; and 37 percent had systolic pressures of 150 mmHg and higher.<\/p>\n<p><strong>They found:<\/strong><\/p>\n<ul>\n<li>Over the median 13 years of follow-up, 182 people developed stroke.<\/li>\n<li>Having a systolic blood pressure of 140 to 149 mmHg elevated stroke risk as much as having systolic blood pressure greater than 150.<\/li>\n<li>Those with 140 mmHg systolic blood pressure and higher at the start of the study were 70 percent more likely to suffer a stroke compared to adults with normal systolic pressure, which is less than 140 mmHg.<\/li>\n<li>The increased stroke risk was most notable among Hispanics and non-Hispanic blacks.<\/li>\n<\/ul>\n<p>\u201cThe findings suggest one should not liberalize or change the treatment threshold for blood pressure in people older than 60 without chronic kidney disease or diabetes. For stroke prevention, maintaining a blood pressure target of 140 mmHg is important,\u201d Sacco said.<\/p>\n<p>There are limitations to the study, according to Sacco. One is that it\u2019s an observational, not a randomized study, which means the researchers observed what happened in the study population rather than randomly assigning people to treatment groups for comparison. A study strength is that it had strong minority representation. That\u2019s important, Sacco said, because blacks and Hispanics have greater risks of stroke and more hypertension than whites.<\/p>\n<p>[320left]\u201cAs a result, more aggressive treatment of blood pressure in those population groups is even more critical,\u201d he said. \u201cIn general, our findings support adherence to the current American Heart Association guidelines that consistently recommend treatment for blood pressure above 140-90 mmHg in order to improve cardiovascular health and reduce stroke.\u201d<\/p>\n<p>Co-authors are: Chuanhui Dong, Ph.D.; David Della-Morte, M.D., Ph.D.; Tatjana Rundek, M.D., Ph.D.; Clinton B. Wright, M.D., M.S.; and Mitchell S. V. Elkind, M.D., M.S.<\/p>\n<p>Author disclosures are on the manuscript.<\/p>\n<p>The National Institutes of Health (NIH) supported the study.<\/p>\n<p><strong>Additional Resources<\/strong><\/p>\n<ul>\n<li>View the <a href=\"http:\/\/hyper.ahajournals.org\/content\/early\/2016\/02\/01\/HYPERTENSIONAHA.115.06857.full.pdf+html\" title=\"\"  target=\"_blank\">manuscript<\/a> online.<\/li>\n<li><a target=\"_blank\" href=\"http:\/\/www.heart.org\/targetBP\" >Target: BP<\/a> \u2013 A new tool for physicians to help increase blood pressure control in their practice<\/li>\n<li><a href=\"http:\/\/www.heart.org\/hbp\" title=\"Heart.org\/hbp\"  target=\"_blank\">Heart.org\/hbp<\/a> \u2013 Information and inspiration to help you take control of your blood pressure<\/li>\n<li>Follow AHA\/ASA news on Twitter <a href=\"http:\/\/twitter.com\/HeartNews\" title=\"@HeartNews\"  target=\"_blank\">@HeartNews<\/a>.<\/li>\n<li>For the latest blood pressure science, follow the <em>Hypertension<\/em> journal at <a href=\"http:\/\/twitter.com\/HyperAHA\" title=\"\"  target=\"_blank\">@HyperAHA<\/a><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Dallas, TX &#8211; Raising the systolic blood pressure threshold from 140 to 150 mmHg, as a new target for high blood pressure treatment in older people who don\u2019t have chronic kidney disease or diabetes, could put this population at greater stroke risk, according to new research in the American Heart Association\u2019s journal Hypertension. The increased [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"footnotes":""},"categories":[86],"tags":[2538,9006,4030,216,215,10390,2558,2863,2543,10725,10569,9005],"class_list":["post-10942","post","type-post","status-publish","format-standard","hentry","category-health","tag-american-heart-association","tag-columbia-university","tag-dallas-tx","tag-diabetes","tag-high-blood-pressure","tag-hispanic","tag-hypertension","tag-kidney-disease","tag-stroke","tag-stroke-risk","tag-systolic-blood-pressure","tag-university-of-miami"],"_links":{"self":[{"href":"https:\/\/www.paristn.net\/articles\/wp-json\/wp\/v2\/posts\/10942","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.paristn.net\/articles\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.paristn.net\/articles\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.paristn.net\/articles\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/www.paristn.net\/articles\/wp-json\/wp\/v2\/comments?post=10942"}],"version-history":[{"count":1,"href":"https:\/\/www.paristn.net\/articles\/wp-json\/wp\/v2\/posts\/10942\/revisions"}],"predecessor-version":[{"id":10943,"href":"https:\/\/www.paristn.net\/articles\/wp-json\/wp\/v2\/posts\/10942\/revisions\/10943"}],"wp:attachment":[{"href":"https:\/\/www.paristn.net\/articles\/wp-json\/wp\/v2\/media?parent=10942"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.paristn.net\/articles\/wp-json\/wp\/v2\/categories?post=10942"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.paristn.net\/articles\/wp-json\/wp\/v2\/tags?post=10942"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}