Deans' stroke musings: Evidence to maintain the systolic blood pressure treatment threshold at 140 mm hg for stroke prevention

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, February 14, 2017

Evidence to maintain the systolic blood pressure treatment threshold at 140 mm hg for stroke prevention

Be careful out there. Mine is currently controlled down to 130/88, it was as high as 205/116.
https://www.mdlinx.com/internal-medicine/medical-news-article/2016/02/11/blood-pressure-cardiovascular-diseases-continental-population/6535849/?

Hypertension, 02/11/2016

Dong C, et al. – Raising the SBP threshold from 140 to 150 mm Hg as a new target for hypertension treatment in older individuals without diabetes mellitus or chronic kidney disease could have a detrimental effect on stroke risk reduction, especially among minority US populations.

Methods

In the Northern Manhattan Study, 1750 participants aged ≥60 years and free of stroke, diabetes mellitus, and chronic kidney disease had SBP measured at baseline and were annually followed up for incident stroke.
Mean age at baseline was 72±8 years, 63% were women, 48% Hispanic, 25% non-Hispanic white, and 25% non-Hispanic black.

Results

Among all participants, 40% were on antihypertensive medications; 43% had SBP <140 mm Hg, 20% had 140 to 149 mm Hg, and 37% had ≥150 mm Hg.
Over a median follow-up of 13 years, 182 participants developed stroke.
The crude stroke incidence was greater among individuals with SBP≥150 mm Hg (10.8 per 1000 person-years) and SBP 140 to 149 (12.3) than among those with SBP<140 (6.2).
After adjusting for demographics, vascular risk factors, diastolic BP, and medication use, participants with SBP 140 to 149 mm Hg had an increased risk of stroke (hazard ratio, 1.7; 95% confidence interval, 1.2–2.6) compared with those with SBP <140 mm Hg.
The increased stroke risk was most notable among Hispanics and non-Hispanic blacks.

Go to PubMed Go to Abstract Print Article Summary Cat 2 CME Report