Stroke Patients Benefit Most from ACC/AHA Hypertension Guidelines

Treating hypertension in individuals with stroke may lower the mortality rate in this patient population by one-third, suggesting that the 2017 hypertension guidelines published by the American College of Cardiology (ACC) and the American Heart Association (AHA) could especially benefit stroke survivors, according to a new study.¹

“The potential to reduce mortality and recurrent stroke is immense, because more than half of all strokes are attributable to uncontrolled high blood pressure,” said Alain Lekoubou, MD, MS, lead study author and clinical instructor in neurology at the Medical University of South Carolina in Charleston.²

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For their study, Dr Lekoubou and colleagues assessed data from the 2003-2014 National Health and Nutrition Examination Surveys (NHANES) on stroke survivors aged 20 years or older.

Data on self-reported stroke and self-reported pharmacological treatment of hypertension were included in the analysis. NHANES protocol were used to estimate blood pressure.

After analyzing the data, the researchers found that the 2017 ACC/AHA guidelines identified approximately 67% more stroke survivors with hypertension and 54% more stroke survivors who did not fall within the recommended blood pressure target compared with the seventh report of the Joint National Committee (JNC) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines.

Specifically, 2,361,075 (49.8%) stroke survivors with hypertension were identified under the 2017 ACC/AHA guidelines vs 1,415,974 (29.9%) under the JNC’s guidelines.

In addition, 1,824,106 (56%) stroke survivors were identified as not falling within recommended blood pressure targets under the 2017 ACC/AHA guidelines vs 1,184,655 (36.3%) under the JNC’s guidelines.

“The new guideline offers physicians and policymakers a unique opportunity to reinforce the already decreasing stroke-related mortality trends of the last few decades,” said Dr Lekoubou. “It is our responsibility to ensure that stroke survivors identified with hypertension are treated more aggressively and to ensure that those on treatment remain on treatment.”²

—Christina Vogt

Reference:

1. Lekoubou A, Bishu KG, Ovbiagele B. Nationwide impact of the 2017 American College of Cardiology/American Heart Association blood pressure guidelines on stroke survivors [Published online June 6, 2018]. J Am Heart Assoc. https://doi.org/10.1161/JAHA.118.008548

2. Stroke survivors could gain the most from new blood pressure guidelines [press release]. Dallas, Texas. American Heart Association. June 6, 2018. https://newsroom.heart.org/news/stroke-survivors-could-gain-the-most-from-new-blood-pressure-guidelines Accessed on June 8, 2018.