Research indicates Hypertension and Stroke that a prolonged high systolic blood pressure is associated with a higher risk of stroke, particularly brain hemorrhages and ischemia. Prevention requires early diagnosis and intervention.
Elevated systolic blood pressure, which is the highest number on a blood pressure reading that indicates the force with which the heart pumps blood into the arteries, has been found in a Michigan Medicine study to increase the risk of the two most common forms of strokes over time. The study examined the mean systolic blood pressure years before the initial stroke in over 40,000 persons who were 18 years of age or older and had never had a stroke before.
Three types of strokes were investigated by the researchers: subarachnoid hemorrhage, which is bleeding between the brain and surrounding tissues, intracerebral hemorrhage, which is bleeding within the brain, and ischemic stroke, which is caused by a clot obstructing blood flow to the brain and accounts for over 85% of all strokes. According to their research, there is a 20% increase in the risk of both ischemic stroke and total stroke and a 31% increase in the chance of intracerebral hemorrhage for every 10 mm Hg increase in systolic blood pressure over normal.
Senior author Deborah A. Levine, M.D., M.P.H., professor of internal medicine and neurology at University of Michigan Medical School, stated, “Our results suggest that early diagnosis and sustained control of high blood pressure over the lifespan are critical to preventing stroke, ischemic stroke, and intracerebral hemorrhage, especially in Black and Hispanic patients who are more likely to have uncontrolled hypertension than White patients.”
Black patients faced a 20% greater risk of ischemic stroke and a 67% higher risk of intracerebral haemorrhage than white patients. In contrast, Hispanic patients had a 281% increased risk of subarachnoid hemorrhage, but no elevated risk for other types of stroke compared to white patients.
Although Black and Hispanic patients had a higher risk of stroke, there was little evidence to suggest that race or ethnicity affected the relationship between cumulative systolic blood pressure and the specific type of stroke that a patient suffered.
First author and University of Michigan postdoctoral research fellow Kimson E. Johnson, PhD, M.A., M.S.W., said, “Examining racial inequities advances our understanding of the social, economic, and political structures that affect health behaviors and risk for stroke among racial and ethnic minority groups.”
Although systolic blood pressure is a modifiable target for preventing stroke and other cardiovascular diseases, a national study from 2020 revealed that blood pressure control in the United States deteriorated from 2013 to 2018, particularly among Black and Hispanic adults. Levine claims that although self-monitoring blood pressure is accurate, economical, and improves diagnosis and control, it is still underutilized.
The absence of patient education and insurance companies’ refusal to pay for the $50 or more cost of home blood pressure monitors are two significant obstacles to self-monitoring blood pressure, the speaker stated.
In order to optimize people’s blood pressure and lower their risk of suffering a stroke, health care systems, providers, and insurers must inform, encourage, and support their patients to undertake at-home blood pressure monitoring.”
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