Thu May 20, 2004 05:22 PM ET
By Anthony J. Brown, MD
NEW YORK (Reuters Health) - One quarter of bleeding strokes
could be prevented if all patients with high blood pressure
were to receive treatment, according to a report in the medical
journal Stroke.
A stroke occurs when blood flow to a brain region is decreased,
either because of a blood clot that blocks blood flow or because
a blood vessel ruptures. This latter type is known as a bleeding,
or hemorrhagic stroke, and it has been strongly linked to high
blood pressure.
"In the past, people have done...trials to see if treatment
of (high blood pressure) could prevent stroke, but no one has
looked to see if such treatment is actually protective against
stroke on a population-based scale," lead author Dr. Daniel
Woo, from the University of Cincinnati in Ohio, told Reuters
Health. "In others words, how much of stroke is being prevented
by treating (high blood pressure)?"
The new findings are based on analysis of hemorrhagic strokes
that took place in the greater Cincinnati region between May
1997 and December 2002. Sixteen hospitals within a 50-mile radius
of the city were screened for cases.
A total of 549 hemorrhagic strokes occurred during the study
period. Compared with normal blood pressure, untreated high
blood pressure raised the risk of stroke by 3.5-fold. Although
treated high blood pressure was still linked to stroke, the
increased risk was greatly reduced to1.4-fold.
On initial analysis, blacks were at increased risk for untreated
high blood pressure, but after adjusting for access to care
factors, such as insurance status, their risk was comparable
to that seen in whites, Woo said.
The authors estimate that up to 28 percent of hemorrhagic strokes
among patients with high blood pressure would have been prevented
if they had been receiving appropriate blood pressure drugs.
The reduction in strokes identified in the current study could
have major economic ramifications, Woo said. "The lifetime
cost for 1 year of hemorrhagic stroke in the US has been estimated
at over $11 billion. Therefore, being able to prevent one fourth
of cases could result in savings of about $2.5 billion,"
he added.
SOURCE: Stroke, May 20th rapid access issue, 2004. |
