Stroke: how to prevent by treating hypertension


Be careful not to treat hypertension too intensely

Treating hypertension too intensely would be associated with a risk of occurrence of a cardiovascular accident. If hypertension in people with heart disease is dangerous for their health, too low a pressure also increases the risk of cardiovascular accidents, according to Professor Philippe Gabriel Steg, lead author of the study.

The optimal blood pressure in patients with hypertension is still under debate. Some argue that the weaker the better but this can lead to insufficient blood flow to the heart in patients with coronary artery disease (damage to the arteries that supply blood to the heart).

The medical data of 22,672 patients with coronary artery disease and treated for hypertension were analyzed to verify whether there was a link between the drop in blood pressure obtained after treatment and possible mortality from myocardial infarction or stroke.

Systolic and diastolic blood pressure were recorded before each cardiovascular event or death that occurred in these patients.


  • Hypertension (with systolic pressure over 140 mmHg and diastolic pressure over 80 mmHg) has been associated with an increased risk of cardiovascular events.
  • Conversely, a systolic blood pressure below 120 mmHg is just as dangerous since it increases the risk of death from myocardial infarction or stroke by 56%. This risk increases by 41% when diastolic blood pressure is below 70 mmHg.

This study suggests that physicians should exercise caution when prescribing an antihypertensive drug intended to lower blood pressure in patients with coronary artery disease.

High blood pressure can be lowered with a healthy lifestyle:

  1. physical activity for at least 30 minutes a day.
  2. Moderate consumption of salt and alcohol.
  3. Follow a diet if necessary.

Source: European Society of Cardiology, Rome, August 2016.

Stroke: be careful not to forget to take your antihypertensive medication

A study reveals that forgetting to take your antihypertensive drug would increase the risk of stroke by 40%.

High blood pressure is a known risk factor for heart attacks and strokes. This new study suggests that sudden fluctuations in blood pressure can also be harmful to the brain. Indeed, forgetting to take your tablets daily considerably increases the variations in blood pressure and therefore the risk of stroke and heart attack.

“Blood pressure fluctuates depending on various factors such as stress and taking medication in particular. While it is difficult to control certain factors, hypertensive patients can nevertheless take care to take their tablets regularly, ”says the principal researcher of the study published in the journal Hypertension.

Lowering ‘normal’ blood pressure in at-risk subjects reduces risk of stroke and heart attack

Treating people at risk of having a heart attack or stroke (CVA) with antihypertensives could be beneficial, even if they have a normal systolic blood pressure (ie less than 130 mmHg). These people at risk suffer from certain pathologies such as kidney disease, diabetes and a heart history…

According to the results of the study involving 600,000 people, each 10 mmHg reduction in systolic blood pressure reduces the risk of heart attacks and strokes by 20 to 25%, and of stroke.

The authors of the study criticize the fact that the European Hypertension Society has raised the blood pressure goals to be achieved from 130/85 mmHg to 140/90 mmHg.

According to the American Heart Association, a so-called  normal pressure is lower than 120/80, and becomes high from 140/90.

Source: Ettehad D et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet, December 2015.

Treating normal blood pressure lowers stroke risk by 22%

On the other hand, the risk of infarction is not reduced.

It is considered that a preventive treatment must be implemented above 140/90 millimeters of mercury in order to reduce the risk of stroke and heart attack.

These results, published in the journal Stroke, suggest that the prescription of antihypertensives could be extended to a category of ‘healthy’ people, an idea which is not shared by part of the medical community which considers that the the same effects could be obtained with a healthy diet, physical activity, reduced salt intake, and reduced alcohol consumption.

In addition, this drug approach is expensive: the researchers have calculated that it would take 169 people to be treated for four years and three months to prevent a single stroke.

Stroke: watch out for hypertension

High blood pressure increases the risk of stroke, according to a review of 19 studies involving more than 760,000 patients.

Between a quarter and half of the individuals had a tension higher than the optimal pressure (that is to say 120/80), but lower than 140/90, threshold from which one considers a person as hypertensive.

The results showed that subjects with a blood pressure greater than 140/90 have a greater risk (+66%) of being victims of a stroke, compared to those with normal blood pressure, regardless of the presence of other factors. (smoking, diabetes, hypercholesterolemia).

It should be noted that those in a gray zone – that is to say with a voltage between 120/80 and 140/90 – are not spared since a quarter of individuals who have suffered a stroke were part of this gray zone (mostly those with blood pressure between 130/85 and 140/90). The main author of the study recommends for this category of individuals to modify their diet and to be more active. The prescription of antihypertensives is not yet recommended.

Source: Prehypertension and the risk of stroke, Neurology, February 2014.