Skip to main content
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Government
March 12, 2014 01:00 AM

Stroke risk high for prehypertensive patients, but best treatment remains uncertain

Sabriya Rice
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    Patients whose blood pressure is higher than the optimal 120/80 mm Hg are 66% more likely to develop a stroke when compared to patients with normal blood pressure, regardless of other risk factors such as high cholesterol, diabetes and smoking, a study says.

    Drug interventions are typically reserved for those who have been diagnosed with “high blood pressure,” but the study suggests that aggressive methods might be needed even for individuals whose BP is consistently elevated, but who are not yet considered to be hypertensive.

    The term “prehypertension” defines patients who have a systolic blood pressure between 120-139 mm Hg, and a diastolic blood pressure between 80- 89 mm Hg, higher than what is recommended, but not enough for a high blood pressure diagnosis. Since the term was proposed in 2003 by the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure, many have disagreed about lumping patients into this category, arguing that the risks and treatment options would be different for those on the higher end.

    How to handle patients who fall in this “gray area” was the topic of new JNC 8 guidelines published in December. The recommendations brought a firestorm of criticism, when they advised against using drugs to treat blood pressure as high as 150 over 90 in people 60 or older. Some said the committee of 17 academics that formulated the new guidelines took too narrow a focus on data from randomized trials.

    This latest study says the risk is high for any patient who has a BP reading above the optimal level.

    Patients on the lower end of the prehypertension range were 44% more likely to develop stroke than patients with normal blood pressure, although the risk was even greater for patients on the higher end, found the meta-analysis published Wednesday in the journal Neurology. Researchers analyzed data from a total of 19 studies from Asia, Europe and the United States, a data set representing more than 760,000 patients.

    “These findings, if confirmed, have important takeaways for the public,” said study author, Dr. Dingli Xu, of Southern Medical University in Guangzhou, China. “Considering the high proportion of the population who have higher than normal blood pressure, successful treatment of this condition could prevent many strokes and make a major difference in public health.”

    Nearly 30% of U.S. adults have prehypertension, according to the Centers for Disease Control. In patients without other risk factors such as diabetes, high cholesterol or family history, the first line of intervention is often to encourage lifestyle adjustments—such as reducing sodium intake, increasing physical activity and losing weight. Some argue that alone may not be enough, as patients who present with these problems often have great difficulty managing the issues on their own. The Neurology study suggests more research into pharmaceutical approaches for this category of patient.

    “For those of us who are trying to prevent stoke, more aggressive control of blood pressure is essential,” agreed Dr. Ralph L. Sacco, chairman of Neurology at the University of Miami School of Medicine, and past president of the American Heart Association. He says lifestyle interventions are very important, but if a patient's blood pressure remains elevated after several unsuccessful attempts, a pharmacological approach may be in order to help preclude a high blood pressure diagnosis.

    “We need to do everything we can to get patients' blood pressure controlled, and that may include medication. This article provides further strong evidence in favor of controlling blood pressure at intermediate levels,” he said.

    Still, experts agree more research is needed on the long-term effects of use of these medications in patients who do not have high blood pressure, in order to avoid overtreatment and unnecessary exposure to known side effects associated with the drugs.

    Follow Sabriya Rice on Twitter: @MHSrice

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    abortion-pill-misoprostol-legal
    Abortion pill case advances to appeals court, on course to Supreme Court
    young doctor medical resident
    Federal physician recruitment program at risk
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing