Longitudinal Study of Blood Pressure and Stroke in over 37,000 People in China

Fang, Xiang; Longstreth, W. T.; Li, Shi Chuo; Kronmal, Richard A.; Cheng, Xue; Wang, Wen Zhi; Wu, Shengping; Du, Xiao Li; Dai, Xiu Ying

doi:10.1159/000047643

Cited by 22 publications

(24 citation statements)

References 7 publications

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“…4,8,9 Briefly, 7 urban clinical medical centers located in Beijing, Shanghai, Changsha, Harbin, Yinchuan, Changchun, and Zhengzhou participated in the study. In each city, 2 geographically separated communities with approximate registered populations of 10 000 each were chosen as study communities.…”

Section: Study Summarymentioning

confidence: 99%

“…1 A 16-year surveillance study showed that the stroke attack rates were continuously increasing annually: by 4.5% in men and 4.2% in women from 1984 to 1999. 2 A substantial number of epidemiological studies in China have demonstrated that stroke is associated with hypertension [3][4][5] and that the prevalence of hypertension has been increasing rapidly in China. 6 Stroke is a strongly age-dependent disease, and the incidence of stroke among people Ͼ60 years of age was 2 to 3 times higher than those Ͻ60 years of age in the Chinese population.…”

mentioning

confidence: 99%

“…The stroke prevention project in China was a community-based program for primary prevention of stroke, implemented in 7 major cities in 1987. 4,8,9 The analysis here intended to explore the association of subtypes of hypertension (ie, ISH, IDH, combined systolic and diastolic hypertension [SDH], and managed hypertension [MHT]), with the risk of stroke incidence in total and in different age groups.…”

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confidence: 99%

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Subtype Hypertension and Risk of Stroke in Middle-Aged and Older Chinese

Fang

Zhang

Yang

et al. 2006

Stroke

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Background and Purpose-Hypertension is the most important indicator of stroke. We aim to compare the long-term effects of the subtypes of hypertension on the risk of stroke in a Chinese cohort. Methods-A total of 26 587 subjects Ն35 years of age and free of stroke were recruited in 5 cities in 1987. The subtypes of hypertension were defined as isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), systolic and diastolic hypertension (SDH), as well as managed hypertension (MHT), according to the criteria of systolic blood pressure Ն140 or diastolic blood pressure Ͼ90 mm Hg or under antihypertensive treatment. The relative risks of stroke with the subtypes of hypertension, compared with normotensives, were estimated using the Cox model after adjustments for age, sex, and other confounders. Results-The prevalence of hypertension was: ISH 7.1%, SDH 18.4%, IDH 6.7%, and MHT 3.9%. During a total of 233 437 person years of follow-up, 1107 subjects developed stroke (614 ischemic and 451 hemorrhagic events and 42 unclassified). SDH patients were at the highest risk of stroke among all the hypertensives. The hazard ratio and 95% CI was 2.96 (2.49 to 3.52) for all stroke, 4.05 (3.10 to 5.30) for hemorrhagic, and 2.33 (1.84 to 2.95) for ischemic stroke. Although the incidence of stroke was higher in the older population, the effect of hypertension, especially SDH, on hemorrhagic stroke is stronger in the middle-aged population. Conclusion-ISH

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Section: Study Summarymentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Subtype Hypertension and Risk of Stroke in Middle-Aged and Older Chinese

Fang

Zhang

Yang

et al. 2006

Stroke

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“…The risk of stroke is increased by approximately 25% with each 10 mm Hg increase in SBP. 3,4,22,23 In the present work, when the rats were divided into 2 groups according to SBP level, the stroke was significantly delayed in the relatively lower SBP group compared with the higher SBP group. Using the parameter measuring the time when 50% of the rats died, it was found that the survival time was 1.43-fold longer in the SBP-low group than in the SBP-high group.…”

Section: Discussionmentioning

confidence: 54%

Arterial Baroreflex

Liu

Shen

et al. 2007

Stroke

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Background and Purpose-Arterial baroreflex is one of the most important mechanisms in the regulation of cardiovascular activities. Arterial baroreflex function can be expressed as baroreflex sensitivity (BRS). The present study was designed to test 2 hypotheses: (1) BRS is a new independent predictor for the incidence of stroke in hypertension, and (2) restoration of BRS can prevent stroke in hypertension. Methods-First, 82 stroke-prone spontaneously hypertensive rats (SHR-SP) aged 28 to 30 weeks were used. After measuring blood pressure and BRS, the survival time was observed. Second, 12 SHR-SP aged 8 months were used. Blood pressure and BRS were determined separately before and after intragastric administration of ketanserin (0.3 and 3.0 mg/kg). Third, SHR-SP aged 5 months were treated with ketanserin for 12 weeks (0.3 mg and 3.0 mg/kg per day). At the end of the treatment, blood pressure and BRS were determined and the end-organ damage was evaluated. Last, SHR-SP aged 3 months were treated with ketanserin (0.3 and 3.0 mg/kg per day) for life and the survival time was recorded. Results-Stroke was significantly delayed in rats with high BRS than those with low BRS (time to 50% death was 1.47-fold longer than low BRS group; PϽ0.01). Ketanserin of 3.0 mg/kg per day decreased blood pressure and enhanced BRS, whereas 0.3 mg/kg per day only enhanced the BRS. Fatal stroke incidences were markedly reduced by treatment with both doses (PϽ0.0001 versus control group). Conclusions-The present study provides evidence that BRS is an independent predictor for stroke in hypertension.Restoration of BRS may be a new strategy for the prevention of stroke.

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“…There is an estimated 25% increase risk of stroke with each 10 mmHg rise in systolic blood pressure and with diastolic blood pressure of more than 110mm Hg have 15 times more risk than the patient with blood pressure less than 80 mmHg. 13 Only by managing one modifiable risk factor (hypertension), there is a decrease chance of stroke by about 38%.…”

Section: Discussionmentioning

confidence: 99%

Stroke; Evaluation of Risk Factors, Clinical Manifestations, and Diagnostic Outcome

Ahmed¹,

Ajaz²,

Iqbal³

2016

TPMJ

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ABSTRACT… Objective: To determine the risk factors, clinical manifestations, and diagnostic outcome of stroke among patients admitted in CMH Jhelum. Study design: Descriptive case series. Place and duration of study: Medicine Department Combined Military Hospital Jhelum Cantonment from January 2013 to February 2014. Material and methods: A sample size of 200 was obtained with an equal number of male and female patients. After formal consent a detailed history was taken regarding hypertension, diabetes mellitus, smoking, and Performa was filled. Investigations like Fasting blood sugar, serum cholesterol, and CT scan brain were also done, other relevant data like name, age, gender, and address, were collected. Patient admitted with clinical presentation of stroke later being diagnosed on CT scan brain as ischemic or hemorrhagic were included. Stroke secondary to vascular lesions, space occupying lesions, and blood dyscrasias were excluded from study because these cases would act as effect modifier and interfere with results, thus producing bias in this study. Results: A total number of 200 patients were included in this study with an equal ratio of male and female. Range of age group was 40 to 80 years while mean age group involved was 70.01 ± 13.02 years old. Most common clinical manifestations were weakness of right half of the body that is 51.5%, weakness left half 25%, and coma 13.5%. Hypertension found to be leading risk factor of stroke with 58.5%, while diabetes found in 24.5%, smoking 8%, obesity 5%, and high cholesterol in 4% of patients. Diagnostic outcome was ischemic stroke in most of the patients (71%) and hemorrhagic stroke in 29%. Conclusion: Modifiable risk factors such as hypertension, diabetes, smoking, obesity and high cholesterol are found to the key risk factors. These can be easily controlled by life style modification and effective medication therapy resulting a significant reduction the morbidity and mortality of stroke. Key words:Stroke, Clinical Manifestations, Etiologies

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Longitudinal Study of Blood Pressure and Stroke in over 37,000 People in China

Cited by 22 publications

References 7 publications

Subtype Hypertension and Risk of Stroke in Middle-Aged and Older Chinese

Subtype Hypertension and Risk of Stroke in Middle-Aged and Older Chinese

Arterial Baroreflex

Stroke; Evaluation of Risk Factors, Clinical Manifestations, and Diagnostic Outcome

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