Thursday, June 9, 2016

Independent and joint effect of brachial-ankle pulse wave velocity and blood pressure control on incident stroke in hypertensive adults

Just in case you need to remind your doctor of all the things you need done to reduce your risk of stroke. I've never had an ankle pulse taken.
http://www.mdlinx.com/internal-medicine/medical-news-article/2016/06/09/antihypertensive-drugs-china-longitudinal-studies-pulse/6709807/?category=latest&page_id=1
 
In this longitudinal study, the researchers aimed to examine the independent and joint effect of brachial–ankle PWV (baPWV) with hypertension control on the risk of first stroke. Aamong hypertensive patients, baPWV and hypertension control were found to independently and jointly affect the risk of first stroke. Participants with high baPWV and inadequate hypertension control had the highest risk of stroke compared with other groups.

Methods

  • A total of 3310 hypertensive adults enrolled, a subset of the China Stroke Primary Prevention Trial (CSPPT) with baseline measurements for baPWV.
  • During a median follow–up of 4.5 years, 111 participants developed first stroke.

Results

  • The risk of stroke was higher among participants with baPWV in the highest quartile than among those in the lower quartiles (6.3% versus 2.4%; hazard ratio, 1.66; 95% confidence interval, 1.06–2.60).
  • Similarly, the participants with inadequate hypertension control had a higher risk of stroke than those with adequate control (5.1% versus 1.8%; hazard ratio, 2.32; 95% confidence interval, 1.49–3.61).
  • When baPWV and hypertension control were examined jointly, participants in the highest baPWV quartile and with inadequate hypertension control had the highest risk of stroke compared with their counterparts (7.5% versus 1.3%; hazard ratio, 3.57; 95% confidence interval, 1.88–6.77).
  • There was a significant and independent effect of high baPWV on stroke as shown among participants with adequate hypertension control (4.2% versus 1.3%; hazard ratio, 2.29, 95% confidence interval, 1.09–4.81).

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