Antihypertensive treatment decrease stroke occurrence: a prospective cohort study

Objective: Among the risk factors of stroke, hypertension was one of the most important and modifiable factors. The current study aimed to assess whether antihypertensive treatment to ideal levels of blood pressure can eliminate stroke risk in a prospective cohort study. Methods: The Kailuan study was a prospective longitudinal cohort study on stroke risk factors and events. We analyzed association of baseline antihypertensive treatment efficacy with the risk of stroke during 11.0-year follow-up, and further evaluated association of newly antihypertensive treatment efficacy at 4-year follow-up with subsequent stroke. Multivariate Cox proportion models were used to calculated hazard ratios and their 95% confidence intervals (CIs) for stroke. Results: A total of 97 772 participants (median age: 51.65 years) without previous stroke were included. At baseline, 55 518 participants had normotension, 2339 treated and controlled, 32 331 untreated hypertension and 7584 treated but uncontrolled. Compared with normotension, individuals with treated and controlled, untreated hypertension and treated but uncontrolled, had 83, 97 and 162% higher risk of developing total stroke after adjusting for potential stroke risk factors, respectively (hazard ratio 1.83 [95% CI 1.56–2.15], 1.97 [95% CI 1.85–2.11] and 2.62 [95% CI 2.40–2.86]; all P < 0.05). Whereas, normotension at baseline, who were newly normotension with antihypertensives at 4-year follow-up, exhibited no elevated total stroke risk (hazard ratio, 1.41 [95% CI 0.87–2.30]). Similar results existed for stroke subtypes (ischemic stroke and hemorrhagic stroke). Conclusion: The data suggest that, antihypertensive treatment to normotensive individuals can reduce stroke risk in a short time.