Years of elevated systolic blood pressure are associated with a heightened risk for the two most prevalent types of stroke. The findings highlight that recognizing and effectively managing high blood pressure from an early age is vital for stroke prevention, particularly in Black and Hispanic individuals, who have a greater tendency for uncontrolled hypertension.
High blood pressure is recognized for increasing the likelihood of stroke in individuals.
However, research conducted by Michigan Medicine focuses on the long-term impacts of sustained high systolic blood pressure—the upper number in blood pressure readings, which reflects the pressure exerted by the heart when pumping blood. It reveals that a higher average blood pressure reading throughout adulthood correlates with an increased likelihood of two common stroke types.
The research, published in JAMA Network Open, examined the average systolic blood pressure years before the first stroke occurrence in over 40,000 individuals aged 18 and older with no prior stroke history.
The researchers looked into three stroke types: ischemic stroke, caused by a clot that restricts blood flow to the brain (accounting for more than 85% of strokes); intracerebral hemorrhage, which involves bleeding within the brain; and subarachnoid hemorrhage, which refers to bleeding between the brain and its protective tissues.
They discovered that an average systolic blood pressure reading that is 10 mm Hg above normal is linked to a 20% higher overall risk of stroke and ischemic stroke, as well as a 31% increased risk of intracerebral hemorrhage.
“Our findings indicate that early detection and consistent management of high blood pressure throughout a person’s life is essential for preventing stroke, particularly ischemic strokes and intracerebral hemorrhages, especially in Black and Hispanic populations who typically experience more uncontrolled hypertension than white populations,” stated senior author Deborah A. Levine, M.D., M.P.H., a professor of internal medicine and neurology at the University of Michigan Medical School.
Black individuals had a 20% elevated risk of ischemic stroke and a 67% increased risk of intracerebral hemorrhage relative to white individuals.
Hispanic individuals faced a staggering 281% higher risk of subarachnoid hemorrhage compared to white individuals but did not demonstrate increased risk for other stroke types.
Even though Black and Hispanic populations displayed higher stroke risks, the researchers found minimal evidence that race and ethnicity influenced the relationship between cumulative systolic blood pressure and the specific type of stroke experienced.
“Investigating racial disparities enhances our understanding of the social, economic, and political factors that shape health behaviors and stroke risks among racial and ethnic minority communities,” remarked Kimson E. Johnson, Ph.D., M.A., M.S.W., the first author and postdoctoral research fellow at the University of Michigan.
Although systolic blood pressure is a changeable target for stroke and cardiovascular disease prevention, a national study in 2020 noted a decline in blood pressure management in the U.S. from 2013 to 2018, particularly among Black and Hispanic adults.
Monitoring blood pressure at home significantly aids in accurate diagnosis and management, yet it is often underutilized, according to Levine.
“Two primary challenges to home blood pressure monitoring are insufficient patient education and the lack of insurance coverage for blood pressure monitors, which can cost $50 or more,” she noted.
“Healthcare systems and providers need to inform and encourage patients to monitor their blood pressure at home, and insurers should cover the costs of these devices to help manage blood pressure effectively and lower the odds of stroke.”
Funding: This research was funded by grant R01 NS102715 from the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health, and the U.S. Department of Health and Human Services.
