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Multicenter Study
. 2019 Oct;42(10):925-933.
doi: 10.1002/clc.23242. Epub 2019 Jul 30.

Short-term blood pressure changes have a more strong impact on stroke and its subtypes than long-term blood pressure changes

Rongrong Guo  1 , Yanxia Xie  1 , Jia Zheng  1 , Yali Wang  1 , Yue Dai  1 , Zhaoqing Sun  2 , Liying Xing  3 , Xingang Zhang  4 , Yingxian Sun  2 , Liqiang Zheng  1
Affiliations
Multicenter Study

Short-term blood pressure changes have a more strong impact on stroke and its subtypes than long-term blood pressure changes

Rongrong Guo et al. Clin Cardiol. 2019 Oct.

Abstract

Background: Elevated blood pressure (BP) is closely related to stroke and its subtypes. However, different time periods changes in BP may result in differential risk of stroke.

Hypothesis: Short-term blood pressure changes have a more strong impact on stroke and its subtypes than long-term blood pressure changes.

Methods: We designed the study on the effects of short- (2008-2010) and long-term (2004-2010) BP changes on stroke events (2011-2017), including 22 842 and 28 456 subjects, respectively. The difference in β coefficients between short- and long-term BP changes on the effects of stroke were examined using the Fisher Z test.

Results: During a median 12.5-year follow-up period, 1014 and 1505 strokes occurred in short- and long-term groups. In short-term group, going from prehypertension to hypertension, the risk of stroke events increased (stroke: hazard ratio [HR] = 1.537 [1.248-1.894], ischemic stroke: 1.456 [1.134-1.870] and hemorrhagic stroke: 1.630 [1.099-2.415]); going from hypertension to prehypertension, the risk of stroke events decreased (stroke:0.757 [0.619-0.927] and hemorrhagic stroke:0.569 [0.388-0.835]). Similarly, in long-term group, going from prehypertension to hypertension, individuals had an increased risk of stroke (1.291, 1.062-1.569) and hemorrhagic stroke (1.818, 1.261-2.623); going from hypertension to prehypertension, participants had a decreased risk of stroke (0.825, 0.707-0.963) and hemorrhagic stroke (0.777, 0.575-0.949). Furthermore, the effects of BP changes during short-term period on stroke events were greater than that in long-term period.

Conclusions: Short- and long-terms BP changes were both associated with the risk of stroke events. Furthermore, short-term BP changes had a stronger impact than did long-term changes on risk of stroke events.

Keywords: blood pressure; blood pressure changes; cohort study; stroke.

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Conflict of interest statement

The authors declare no potential conflict of interests.

Figures

Figure 1
Figure 1
Study designs used for analysis of the associations between short‐ and long‐term blood pressure changes and stroke events. Description of baseline and three follow‐up surveys A. Effects of short‐term B, and long‐term C, blood pressure changes on stroke events
Figure 2
Figure 2
The incidence of stroke and its subtypes with short‐term and long‐term blood pressure changes. Stroke, A; ischemic stroke, B; hemorrhagic stroke, C; Nor, normotension; Pre, prehypertension; Hyp, hypertension. Error bars represent 95% CI
Figure 3
Figure 3
The cumulative incidence of stroke with short‐term and long‐term blood pressure changes. Short‐term blood pressure changes, A; long‐term blood pressure changes, B; Nor, normotension; Pre, prehypertension; Hyp, hypertension
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